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Features of Left Atrial Appendage Thrombosis in Patients With Persistent Nonvalvular Atrial Fibrillation After

E S Mazur1, V V Mazur1, N D Bazhenov1

  • 1Tver State Medical University, Tver.

Kardiologiia
|February 7, 2023
PubMed

Insights

Patients with persistent atrial fibrillation (AF) who contracted COVID-19 experienced a 2.5-fold increase in left atrial appendage (LAA) thrombosis. These post-COVID-19 thrombi were predominantly mural and dissolved faster with anticoagulant therapy.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Thrombosis Research

Background:

  • Persistent nonvalvular atrial fibrillation (AF) increases stroke risk.
  • COVID-19 has been linked to various cardiovascular complications, including thrombotic events.
  • The impact of COVID-19 on left atrial appendage (LAA) thrombosis in AF patients requires further investigation.

Purpose of the Study:

  • To determine the incidence and characteristics of LAA thrombosis in patients with persistent nonvalvular AF following COVID-19 infection.
  • To compare LAA thrombosis features between patients with and without a history of COVID-19.

Main Methods:

  • Transesophageal echocardiography (TEE) was performed on 469 patients with persistent nonvalvular AF.
  • 131 patients (27.9%) had experienced a recent COVID-19 infection.
  • All patients received adequate anticoagulant therapy prior to TEE.

Main Results:

  • LAA thrombus incidence was significantly higher in post-COVID-19 patients (14.5%) compared to those without COVID-19 (5.9%).
  • Mural thrombi were more prevalent in COVID-19 survivors (94.7%) versus non-COVID-19 patients (25.0%).
  • Mural thrombi dissolved twice as fast as typical thrombi under anticoagulant treatment.

Conclusions:

  • Patients with persistent AF and a history of COVID-19 exhibit a 2.5-fold increased risk of LAA thrombosis.
  • Mural LAA thrombi, more common after COVID-19, show distinct characteristics and faster dissolution rates with anticoagulation.
  • These findings highlight the prothrombotic potential of COVID-19 in AF patients and inform management strategies.

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