Morphology and Function Assessment of Left Atrial Appendage in Patients With Atrial Fibrillation

Area of Science:

• Cardiology
• Medical Imaging

Background:

• Atrial fibrillation (AF) is a common arrhythmia with significant stroke risk.
• Current risk scores like CHA₂DS₂-VAS_C may underestimate stroke risk in some AF patients.
• The left atrial appendage (LAA) is a primary site for thrombus formation in AF.

Purpose of the Study:

• To highlight the importance of LAA thrombus identification for stroke risk stratification in AF.
• To review the anatomical and physiological aspects of the LAA.
• To discuss the role of imaging in assessing LAA morphology and function.

Main Methods:

• Review of current literature on atrial fibrillation, stroke risk, and left atrial appendage.
• Discussion of imaging modalities, particularly echocardiography, for LAA assessment.
• Analysis of LAA anatomy, physiology, and thrombus formation.

Main Results:

• The LAA is the most common site for thrombus formation in both valvular and nonvalvular AF.
• Thrombi in the LAA are critical to identify for clinical decision-making.
• Imaging is essential for evaluating LAA before, during, and after procedures like AF ablation and LAA occlusion.

Conclusions:

• Enhanced thromboembolic risk stratification in AF patients is necessary.
• Accurate assessment of LAA morphology and function using imaging is crucial for managing stroke risk.
• Understanding LAA anatomy and physiology aids in clinical practice and interventional procedures.