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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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How the trabeculae protrude within the left atrial appendage is the key factor affecting thrombosis in patients with

Juanzhang Liu1, Taihui Yu2, Chaodi Tan1

  • 1Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, People's Republic of China.

The International Journal of Cardiovascular Imaging
|September 4, 2023
PubMed

Insights

Trabeculae protruding angle (TPA) in the left atrial appendage (LAA) is significantly associated with thrombosis risk in non-valvular atrial fibrillation patients. Increased TPA independently predicts LAA thrombus and sludge formation, offering a new risk assessment tool.

Area of Science:

  • Cardiovascular Medicine
  • Medical Imaging
  • Thrombosis Research

Background:

  • The left atrial appendage (LAA) is a primary site for thrombus formation in patients with non-valvular atrial fibrillation.
  • The relationship between the protrusion of myocardial trabeculae within the LAA and the occurrence of thrombosis has not been previously established.

Purpose of the Study:

  • To investigate the association between the degree of trabeculae protrusion in the LAA and the presence of LAA thrombosis or sludge.
  • To evaluate the trabeculae protruding angle (TPA) as a potential independent risk factor for LAA thrombosis.

Main Methods:

  • Retrospective study of 485 patients with non-valvular atrial fibrillation undergoing radiofrequency ablation.
  • Patients categorized into thrombus, sludge, and normal groups based on LAA imaging.
  • Trabeculae protruding angle (TPA) quantified using CT scans; clinical data and LAA emptying velocity collected for comparison.

Main Results:

  • The average TPA was significantly higher in the thrombus and sludge groups compared to the normal group.
  • A positive correlation was observed between increasing TPA and the incidence of LAA thrombus and sludge.
  • Multivariate analysis identified TPA as an independent risk factor for both LAA thrombus (OR=1.046) and sludge (OR=1.035).

Conclusions:

  • The trabeculae protruding angle (TPA) is a reliable measure reflecting LAA trabeculae protrusion.
  • Elevated TPA is an independent risk factor for developing LAA thrombus or sludge in non-valvular atrial fibrillation patients.
  • TPA serves as a potential imaging biomarker for assessing future thrombosis risk in the LAA.

Keywords:
Atrial fibrillationLeft atrial appendageThrombosisTrabeculae protrusion

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