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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Morphometrical features of left atrial appendage in the atrial fibrillation patients subjected to left atrial

K M Słodowska1, J Batko1, J P Hołda1

  • 1Heart Embryology and Anatomy Research Team (HEART), Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland.

Folia Morphologica
|September 27, 2022
PubMed

Insights

Patients with atrial fibrillation exhibit significantly larger and more oval left atrial appendage (LAA) orifices compared to controls. LAA ejection fraction is also notably lower in these patients, impacting stroke prevention strategies.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Anatomy

Background:

  • Atrial fibrillation (AF) poses a stroke risk, often linked to the left atrial appendage (LAA).
  • Understanding LAA morphology is crucial for stroke prevention strategies like LAA percutaneous closure (LARIAT).

Purpose of the Study:

  • To compare the morphometrical features of the left atrial appendage (LAA) in patients with atrial fibrillation (AF) undergoing LARIAT versus control subjects in sinus rhythm.
  • To identify specific anatomical differences that may predispose individuals to AF or influence stroke risk.

Main Methods:

  • Computed tomography (CT) scans from 51 AF patients and 50 sinus rhythm controls were analyzed.
  • Three-dimensional reconstructions using volume-rendering visualized and evaluated LAA morphometry.

Main Results:

  • AF patients had significantly larger LAA orifice dimensions (anteroposterior, transverse diameters, area, perimeter) and a higher prevalence of oval orifices.
  • No significant differences were observed in LAA body type distribution, length, width, or chamber depth between groups.
  • LAA ejection fraction was significantly lower in AF patients (16.4%) compared to controls (48.2%).

Conclusions:

  • Significant morphometrical differences exist in the LAA orifice between AF and control groups, characterized by larger, more oval openings in AF patients.
  • Despite similar LAA body morphology, reduced LAA ejection fraction in AF patients highlights functional differences.
  • These findings underscore the importance of LAA morphology in AF pathophysiology and stroke risk assessment.
Abstract

Keywords:
atrial fibrillationleft atrial appendage closureleft atrial appendage shapestroke

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