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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Association Between Left Atrial Appendage Morphology and Function and the Risk of Ischaemic Stroke in Patients with

Katarzyna Dudziñska-Szczerba1, Piotr Kułakowski2, Ilona Michałowska3

  • 1Department of Cardiology, Centre of Postgraduate Medical Education, Grochowski Hospital, Warsaw, Poland.

Arrhythmia & Electrophysiology Review
|July 18, 2022
PubMed

Insights

Atrial fibrillation (AF) increases stroke risk. New left atrial appendage (LAA) factors may improve stroke risk assessment beyond the CHA2DS2-VASc score, though current evidence is conflicting.

Area of Science:

  • Cardiology
  • Neurology
  • Medical Imaging

Background:

  • Atrial fibrillation (AF) is a common arrhythmia and a significant risk factor for stroke.
  • Current stroke risk stratification in AF patients relies on the CHA2DS2-VASc score.
  • Some AF patients with low CHA2DS2-VASc scores still experience strokes, necessitating improved risk assessment.

Purpose of the Study:

  • To explore novel factors for predicting thromboembolic events in AF patients.
  • To investigate the role of left atrial appendage (LAA) parameters in cardioembolic stroke risk.
  • To assess if LAA characteristics can enhance the predictive performance of the CHA2DS2-VASc score.

Main Methods:

  • Review of studies investigating LAA anatomical and functional parameters.
  • Analysis of factors such as LAA morphology, dimensions, volume, and flow dynamics.
  • Evaluation of the association between LAA parameters and stroke risk in AF populations.

Main Results:

  • Over 90% of embolic strokes originate from the LAA.
  • Several LAA parameters (morphology, lobes, dimensions, volume, trabeculations, flow velocity, strain rate) have been suggested as stroke risk predictors.
  • Existing studies show conflicting results, and no new parameter has been integrated into clinical scores.

Conclusions:

  • LAA characteristics hold potential for improving thromboembolic risk stratification in AF.
  • Further research is needed to resolve conflicting findings and validate new predictive parameters.
  • Enhanced risk assessment could lead to more personalized stroke prevention strategies in AF patients.

Keywords:
AFLeft atrium appendageischaemic stroke

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