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Updated: Jul 9, 2026

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
28:13

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

Published on: February 26, 2013

Poor Distal Left Atrial Appendage Opacification on Early-Phase Cardiac CTA and Association With Arterial

Tao He1,2, Cong Lu1, Tiantian Luo1

  • 1Department of Cardiology and Center of Structure Heart Disease, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, 610072 Chengdu, Sichuan, China.

Reviews in Cardiovascular Medicine
|July 8, 2026
PubMed

Insights

Poor contrast opacification in the left atrial appendage (LAA) on cardiac CT angiography is linked to a higher risk of stroke and arterial embolism in non-valvular atrial fibrillation (AF) patients. This finding may improve thromboembolic risk assessment beyond current scores.

Area of Science:

  • Cardiology
  • Radiology
  • Medical Imaging

Background:

  • Poor contrast opacification (PCO) in the distal left atrial appendage (LAA) on early-phase cardiac computed tomography angiography (CTA) may indicate impaired LAA hemodynamics and blood stasis.
  • This condition is potentially linked to an increased risk of thrombus formation and subsequent embolic events.

Purpose of the Study:

  • To investigate the association between early-phase LAA-PCO and the occurrence of arterial thromboembolic events.
  • To evaluate the predictive value of LAA-PCO and related imaging ratios for thromboembolic events in patients with non-valvular atrial fibrillation (AF).

Main Methods:

  • A retrospective cohort study analyzed 389 adult patients with non-valvular AF who underwent cardiac CTA.
  • Qualitative LAA-PCO and quantitative Hounsfield unit (HU) measurements were recorded. O/D and corrected O/D ratios were calculated.
  • Multivariate logistic regression assessed associations with ischemic stroke and arterial embolism; model discrimination was evaluated using the C-index.

Main Results:

  • 104 patients (26.7%) experienced arterial embolic events, predominantly ischemic strokes (102 events).
  • LAA-PCO was more frequent in the embolic group (27.88% vs. 13.68%).
  • CHA2DS2-VASc score, LAA-PCO, O/D ratio, and corrected O/D ratio were independently associated with arterial embolism. A combined model achieved a C-index of 0.87.

Conclusions:

  • Poor distal LAA opacification on early-phase CTA is significantly associated with arterial thromboembolism in non-valvular AF patients.
  • LAA-PCO may offer complementary information for thromboembolic risk stratification beyond the CHA2DS2-VASc score.
  • Prospective validation and standardization of CT protocols are recommended for clinical application.
Abstract

Keywords:
atrial appendageatrial fibrillationcomputed tomography angiographystrokethromboembolism

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