3D-computed tomography to compare the dimensions of the left atrial appendage in patients with normal sinus rhythm and those with paroxysmal atrial fibrillation

2018 ◽  
Vol 33 (7) ◽  
pp. 777-785 ◽  
Author(s):  
Maiko Hozawa ◽  
Yoshihiro Morino ◽  
Yuki Matsumoto ◽  
Ryoichi Tanaka ◽  
Kyohei Nagata ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Paroxysmal Atrial Fibrillation ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Normal Sinus Rhythm ◽  
Atrial Appendage ◽  
3D Computed Tomography ◽  
Normal Sinus

Abstract 14676: Landmark-based Functional Computed Tomography Reveals Diminished Left Atrial Appendage Contraction During Atrial Fibrillation

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Jonathan H Chung ◽  
Gordon Ho ◽  
Andrew Schluchter ◽  
Francisco Contijoch ◽  
Jonathan C Hsu ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Atrial Fibrillation ◽  
Ejection Fraction ◽  
Sinus Rhythm ◽  
Ct Scan ◽  
Blood Volume ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
History Of

Introduction: The formation of thrombus in the left atrial appendage (LAA) and risk for systemic embolization may result in part from stasis and poor blood volume emptying during atrial fibrillation (AF). Functional 4-dimensional computed tomography (4DCT) is a promising technique to measure LAA ejection fraction and blood volume emptying. Hypothesis: We hypothesize that the LAA ejection fraction measured by 4DCT is decreased during AF compared to sinus rhythm. Methods: 256-slice 4DCT scans obtained in patients for coronary artery imaging or pre-procedurally for AF, VT or SVT ablation procedures were analyzed retrospectively. In each patient, LAA volumes were measured at multiple phases during one cardiac cycle using segmentation software (ITK-SNAP and Osirix MD). LAA ejection fraction was calculated as the difference between minimum and maximum volumes and was analyzed using Wilcoxon rank sum. Results: Out of 54 patients, 37 patients were in sinus rhythm and 17 patients were in AF. Between NSR vs. AF, mean age was 69.1±12.8 vs 73.2±11.5 years (p=0.13), 28% vs 36% female (p=0.54), LVEF was 58±11% vs 60±9% (p=0.95), and echo-derived left atrial volume index was 29.5±6.1 ml/m2 vs 41.7±12.8 ml/m2 (p=0.06). Patients who were in sinus rhythm during their CT scan had a higher LAA ejection fraction than those who were in AF (58±13% vs. 29±9%, p<0.0001). For patients who were in AF during their CT scan, there was no difference in LAA ejection fraction between patients with a history of paroxysmal AF compared to patients with a history of persistent AF (30±10% vs. 28±10%, p=0.75). Conclusions: Analysis of the LAA volumes using functional cardiac CT is a feasible method to quantify blood volume emptying from the LAA. Patients in AF were observed to have significantly decreased LAA ejection fraction and blood volume emptying compared to patients in sinus rhythm. Further studies are needed to determine whether this technique may improve personalized risk stratification for stroke.

Left Atrial Appendage Aneurysm with Paroxysmal Atrial Fibrillation

2012 ◽  
Vol 15 (1) ◽  
pp. 1 ◽  
Author(s):  
Yu-Jen Shih ◽  
Yi-Chang Lin ◽  
Yi-Ting Tsai ◽  
Chih-Yuan Lin ◽  
Chung-Yi Lee ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Paroxysmal Atrial Fibrillation ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Surgical Intervention ◽  
Atrial Appendage ◽  
Atrial Tachyarrhythmia ◽  
Large Aneurysm ◽  
Left Atrial Appendage Aneurysm

Aneurysm of the left atrial appendage is extremely rare, and afflicted patients most commonly present with atrial tachyarrhythmia or thromboembolism. For these patients, resection of the aneurysm is the recommended and preferred therapy. We present the case of a 57-year-old woman who was found incidentally to have a large aneurysm of the left atrial appendage presenting as atrial fibrillation. After surgical intervention with resection of the aneurysm and a Cox maze III procedure, the patient recovered and was discharged in sinus rhythm.

scholarly journals STUDY OF PREVALENCE AND FACTORS INFLUENCING THE OCCURRENCE OF LEFT ATRIAL/ LEFT ATRIAL APPENDAGE CLOT IN PATIENTS WITH RHEUMATIC HEART DISEASE & MITRAL STENOSIS IN SINUS RHYTHM VS ATRIAL FIBRILLATION.

2020 ◽  
pp. 1-4
Author(s):  
Ashish Chauhan ◽  
Rajeev Kumar Gupta ◽  
V.V. Agarwal
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Mitral Stenosis ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Normal Sinus Rhythm ◽  
Atrial Appendage ◽  
Clot Formation ◽  
Spontaneous Echo Contrast ◽  
Significant Difference

BACKGROUND: The purpose of this study was to prospectively evaluate a large group of consecutive, non-anticoagulated patients with RHD (rheumatic mitral stenosis) and to analyze the left atrial appendage function in relation to left atrial appendage clot and spontaneous echo contrast formation in patients who were in SR vs. in AF. METHODS AND RESULTS: This is a hospital based observational study conducted in department of cardiology, S. M. S. MEDICAL COLLEGE and associated hospital, Jaipur, Rajasthan; between march 2016 to august 2017. We prospectively studied clinical and echocardiographic parameters of LA/LAA in 303 consecutive patients with mitral stenosis who underwent trans-esophageal echocardiography and correlated it with spontaneous echo contrast and left atrial appendage clot. The mean age of the patients was 32.94 years. One hundred thirty seven (45.21%) patients were in atrial fibrillation and 166 (54.79%) patients were in sinu rhythm. We found a statistically significant difference in the age of presentation (29.16/33.93/36.68 Yr; P =0.006/<0.001), MVA (1.17/0.8/0.69 cm2; P=<0.001/0.024), LA diameter (39/47.24/50 cm; P=<0.001/<0.001), LAA emptying velocity (45/26.43/15 cm/sec; P=<0.001/<0.001) and EF (37.49/30.67/23.7%; P=<0.001/0.001) among the patients without spontaneous echo contrast /clot vs. with spontaneous echo contrast vs. with spontaneous echo contrast & clot. By using student t-test, we found that there was a statistically significant difference in age of presentation, BMI, MDG, LA diameter, LAA emptying velocity and EF in patients who were in sinus rhythm vs. atrial fibrillation (P<0.05). Incidence of spontaneous echo contrast was 68.67% vs. 91.97% in patients in sinus rhythm vs atrial fibrillation, while that of SEC & CLOT both was 4.22% vs. 33.58% in patients in SR vs AF. In a subgroup of the patients with LA/LAA clot, the LA diameter (55.14 : 49.98 CM; P=0.057) and the LAA emptying velocity ( 15.14 : 15.26 CM/Sec; P=0.923) were not significantly different among patients in SR vs in AF. CONCLUSION: In the patients with severe mitral stenosis, besides atrial fibrillation, a subgroup of patients in normal sinus rhythm with depressed left atrial appendage function had a higher risk of clot formation in left atrial appendage and these patients should be routinely anticoagulated for prevention of clot formation.

P3731The improvement in left atrial strain among patients undergoing percutaneous left atrial appendage closure

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Ijuin ◽  
A Hamadanchi ◽  
F Haertel ◽  
L Baez ◽  
C Schulze ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Transesophageal Echocardiography ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Lateral Wall ◽  
Bleeding Risk ◽  
Atrial Appendage ◽  
Left Atrial Appendage Closure ◽  
Left Atrial Strain

Abstract Background Percutaneous left atrial appendage closure (LAAC) is being established as an alternative option for atrial fibrillation (AF) patients with high bleeding risk. Few studies reported the influence of percutaneous LAAC on left atrial (LA) performance, but most of the studies demonstrated no remarkable changes in their parameters after the procedure. Method The study included 95 patients (age: 75±6.7 years, 67% male) whom underwent percutaneous LAAC in a single center between September 2012 and November 2018. LA strain was evaluated at three different time intervals by transesophageal echocardiography (baseline, 45 days and 180 days after procedure). All data were analyzed using a dedicated. 70 patients had atrial fibrillation whereas 25 were in sinus rhythm. Analysis was performed for peak atrial longitudinal strain (PALS) and peak atrial contraction strain (PACS) from segment of lateral wall in mid-esophageal 4 chamber view. The validity of lateral wall left atrial analysis was recently shown by our group. PACS was obtained in patients with sinus rhythm during exams. Results Compared to baseline, PALS was significantly increased after 45 days (12.4±8.4% vs 16.0±10.7%, p=0.001) and remained stable after 180 days (13.8±9.0% vs 17.0±12.4%, p=0.098). Even in only patients with atrial fibrillation during exams, it was increased (10.8±7.7% vs 13.4±7.1%, p=0.012 and 8.5±5.1% vs 13.9±8.1%, p=0.014). Similarly, compared with the baseline, PACS was significantly increased after 45 days and 180 days (5.8±3.9% vs 10.6±7.6%, p=0.001 and 4.5±2.6% vs 7.9±3.1%, p=0.036). The Changes in PALS and PACS Conclusion Our study has demonstrated for the first time the improvement in LA strain following LAAC within 45 days of implantation by transesophageal echocardiography and these values were maintained at least for 6 months. Further appraisal is warranted for confirmation of these preliminary findings.

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