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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

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Analysis of risk factors for left atrial appendage thrombus formation in patients with atrial fibrillation

Masanori Nishimura1,2, Mitsuhiro Yano3, Atsuko Yokota3

  • 1Department of Cardiovascular Surgery, Miyazaki Medical Association Hospital, Miyazaki, Japan. masanori_nishimura@med.miyazaki-u.ac.jp.

General Thoracic and Cardiovascular Surgery
|November 24, 2025
PubMed

Insights

Predictors of left atrial appendage thrombus include moderate or greater aortic stenosis and increased atrial natriuretic peptide amyloid deposition. Moderate or greater mitral regurgitation was a negative predictor, offering insights into thrombus formation.

Area of Science:

  • Cardiology
  • Pathology

Background:

  • Left atrial appendage (LAA) thrombus formation is a significant risk factor for stroke in patients with atrial fibrillation.
  • Identifying predictors of LAA thrombus is crucial for risk stratification and stroke prevention strategies.

Purpose of the Study:

  • To identify independent predictors of left atrial appendage thrombus formation in patients with atrial fibrillation undergoing cardiovascular surgery.
  • To investigate the role of aortic stenosis, mitral regurgitation, and atrial natriuretic peptide (ANP) amyloid deposition in LAA thrombus development.

Main Methods:

  • Retrospective analysis of 128 patients with atrial fibrillation (AF) who underwent cardiovascular surgery.
  • Histological evaluation of resected left atrial appendages for thrombus and ANP amyloid deposition.
  • Comparison of clinical data, echocardiographic findings, and ANP amyloid grades between thrombus and no-thrombus groups.

Main Results:

  • Left atrial appendage thrombus was present in 21.9% of patients.
  • Moderate or greater aortic stenosis was significantly more frequent in the thrombus group (p=0.004).
  • Higher degree of ANP amyloid deposition was an independent predictor of LAA thrombus (p<0.001), while moderate or greater mitral regurgitation was a negative predictor.

Conclusions:

  • Moderate or greater aortic stenosis and a higher degree of ANP amyloid deposition are significant predictors of LAA thrombus formation.
  • Moderate or greater mitral regurgitation acts as a negative predictor for LAA thrombus.
  • These findings contribute to understanding LAA thrombus pathophysiology and may inform clinical decision-making.
Abstract

Keywords:
Aortic stenosisAtrial fibrillationAtrial natriuretic peptide amyloidLeft atrial appendage thrombus formationValvular diseases

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