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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Interatrial block predicts left atrial appendage thrombus in nonvalvular atrial fibrillation

Elmas Kaplan1, Firdevs Aysenur Ekizler2, Halenur Saribas3

  • 1Department of Cardiology, Cankırı State Hospital, Cankırı, Turkey.

Journal of Electrocardiology
|September 5, 2025
PubMed

Insights

Interatrial block (IAB) is linked to left atrial appendage (LAA) thrombus in nonvalvular atrial fibrillation (NVAF) patients. This electrocardiographic finding may help identify individuals at higher risk for blood clots.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Diagnostics

Background:

  • Interatrial block (IAB) signifies atrial conduction delay and remodeling.
  • IAB is associated with atrial fibrillation (AF) and thromboembolic events.
  • The predictive role of IAB for left atrial appendage (LAA) thrombus is not well-established.

Purpose of the Study:

  • To investigate the association between IAB and LAA thrombus presence.
  • To evaluate IAB as a predictor of LAA thrombus in patients with nonvalvular AF (NVAF) undergoing rhythm control procedures.

Main Methods:

  • Retrospective observational study of 750 NVAF patients undergoing transesophageal echocardiography (TEE) before rhythm control.
  • P-wave parameters analyzed from 12-lead ECGs; IAB defined by consensus criteria.
  • Multivariate logistic regression used to identify independent predictors of LAA thrombus.

Main Results:

  • LAA thrombus detected in 10.8% of patients.
  • Patients with thrombus were older, had higher risk scores, more strokes, and lower LVEF.
  • IAB (OR: 2.698; p=0.008), larger LA diameter, lower LVEF, and P-wave dispersion independently predicted thrombus.

Conclusions:

  • Interatrial block is an independent predictor of LAA thrombus in NVAF patients.
  • IAB may serve as a noninvasive marker for identifying patients with increased thromboembolic risk.
  • Findings may guide the need for TEE prior to rhythm control interventions.
Abstract

Keywords:
Atrial fibrillationBaye's syndromeInteratrial blockLeft atrial appendagethrombus

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