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Updated: May 7, 2026
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
Reduced Left Atrial Appendage Flow Velocity as a Risk of Thromboembolic Events After Catheter Ablation of Atrial
Shintaro Yamagami1,2, Satoshi Shizuta1, Munekazu Tanaka1
1Department of Cardiovascular Medicine Kyoto University Graduate School of Medicine Kyoto Japan.
Background:
Reduced left atrial appendage flow velocity (LAAFV) on transesophageal echocardiography (TEE) is recognized as a predictor of thromboembolic events (TEs) in patients with atrial fibrillation (AF). However, its long-term prognostic value following AF ablation remains unclear.
Methods And Results:
We retrospectively evaluated 1521 patients undergoing AF ablation who underwent preprocedural TEE. Patients were categorized into two groups based on LAAFV: reduced (≤ 21.4 cm/s, n = 99) and preserved (> 21.4 cm/s, n = 1422). The primary outcome was TEs. Secondary outcomes included arrhythmia recurrence and major adverse cardiovascular events (MACEs), defined as a composite of all-cause death, stroke, major bleeding, and heart failure hospitalization, as well as individual components and cardiovascular mortality. Over a mean follow-up of 49 ± 32 months, TEs occurred in 19 patients (1.2%). The 5-year cumulative incidence of TEs was significantly higher in the reduced LAAFV group (6.7% vs. 0.9%, p < 0.0001), despite a lower rate of anticoagulation discontinuation (20.1% vs. 57.1%, p < 0.0001). Multivariable analysis identified reduced LAAFV as an independent predictor of TEs. It was also associated with higher risks for all secondary endpoints.
Conclusions:
Reduced preprocedural LAAFV is associated with adverse long-term clinical outcomes after AF ablation, including a significantly increased risk of thromboembolic events.
