Diltiazem Does Not Prevent Postoperative Atrial Fibrillation After Thoracoscopic Lobectomy

Objective Thoracoscopic lobectomy is associated with lower rates of adverse events compared to thoracotomy. Despite this, postoperative atrial fibrillation (POAF) occurs in at least 10% of patients. Our objective is to determine if prophylaxis with diltiazem significantly reduced POAF events. Methods Patients without prior history of atrial fibrillation who underwent thoracoscopic lobectomy from 2007 to 2016 at one institution were analyzed in a retrospective cohort study utilizing a prospective database. Patients treated from 2007 to 2012 received no prophylaxis. Patients treated after 2012 received diltiazem postoperatively. All patients were monitored with continuous telemetry postoperatively. Multivariate direct logistic regression was performed to determine independent predictors of POAF. We report adjusted odds ratios and accompanying 95% confidence intervals, with P < 0.05 denoting statistical significance. Results The final regression model included 416 patients (52 with POAF, 364 without). In univariate analysis, the variables of body mass index and history of congestive heart failure, diabetes, or hypertension, and prophylaxis status did not meet inclusion criteria. Age, gender, history of stroke or transient ischemic attack, and vascular disease were included. Only ages 65 to 74 ( P = 0.03) and ≥75 ( P = 0.02), compared to <65, were statistically significant predictors of POAF. Adjusted odds ratios of ages 65 to 74 and ≥75 were 2.88 and 2.62, respectively. Conclusions Diltiazem prophylaxis did not significantly reduce POAF incidence following thoracoscopic lobectomy. Further study is warranted since POAF remains an unwanted source of morbidity and cost for lobectomy patients.

Download Full-text

Prevalence of device-detected atrial fibrillation and stroke in patients with hypertrophic cardiomyopathy

European Heart Journal ◽

10.1093/ehjci/ehaa946.2094 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

C Fumagalli ◽

R Ruggieri ◽

V De Filippo ◽

F Cappelli ◽

M Beltrami ◽

...

Keyword(s):

Atrial Fibrillation ◽

Hypertrophic Cardiomyopathy ◽

De Novo ◽

Multivariable Analysis ◽

Prior History ◽

Thromboembolic Events ◽

Cardiac Implantable Electronic Devices ◽

History Of ◽

Ischemic Attack

Abstract Introduction Atrial fibrillation (AF) is highly prevalent in patients with hypertrophic cardiomyopathy (HCM) and is associated with adverse outcome, impaired quality of life, loss of productivity, and the risk for embolic stroke. However, still today, the real burden of AF is unresolved due to the unknown frequency of silent asymptomatic episodes. Purpose To assess the prevalence of device-detected AF and stroke in patients with HCM implanted with cardiac implantable electronic devices (CIEDs) at our institution, a long-standing high flow referral center for cardiomyopathies. Methods Clinical and instrumental data of HCM patients implanted with CIEDs (either pacemakers [PM] or implantable cardioverter defibrillator [ICD]) from 1998 to 2019 were retrospectively reviewed. Inclusion criteria were site-designated diagnosis of HCM, age at diagnosis >18 years, >1 follow up visit, follow up >1 year. HCM phenocopies (e.g. Fabry disease) were carefully excluded. Patients were divided into three categories according to presence of AF (“AF prior to CIED implantation” vs “AF after CIED implantation” vs “no arrhythmia detected”). Outcome was measured against prevalence of thromboembolic events (stroke or transient ischemic attack [TIA]) at follow up. All-cause and cardiovascular (CV) mortality were also assessed. Results A total of 255 patients received a CIED (57% men, mean age at implantation 54±17 years). Men were younger at implantation (52±17 vs 56±18 years, p=0.022). At baseline, AF was present in 90 (35.3%) patients. During 5.0±4.1 years, de novo AF was detected in 30 (11.8%) individuals, resulting in an annual incidence rate of 6.1%/year. Overall, 135 (52.9%) of patients remained is sinus rhythm. Stroke/TIAs were reported in 30 (11.8%) patients: 16 (53.3%) occurred in patients with prior history of AF, 3 (10%) in patients with de novo AF (with men being at higher risk, OR 3.73, 95% CI 1.88–6.09, p=0.041), and 11 (36.7%) in patients with no history of arrhythmias. Long term, 45 (17.6%) patients died (CV mortality N=38, 14.9%). At multivariable analysis, history of stroke was directly related to all-cause mortality irrespective of AF in men (OR 4.15, 95% CI 1.35–12.77, p=0.018) but not in women (OR 0.891, 95% CI 0.17–4.64, p=0.801). Conclusions In a large cohort of consecutive high risk HCM patients referred to CIED implantation, the incidence of de-novo AF was high. Thromboembolic events were associated to worse outcome only in men, likely due to competing heart failure related causes in women. Strategies promoting early identification of AF and anticoagulation may play an important role in management and prevention of disease-related complications. Prevalence of AF and Stroke Funding Acknowledgement Type of funding source: None

Download Full-text

Abstract 14: The Influence of Provider Specialty on Anticoagulation Prescription Fills and Stroke Risk in Atrial Fibrillation Patients With History of Cancer

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.11.suppl_1.14 ◽

2018 ◽

Vol 11 (suppl_1) ◽

Author(s):

Wesley T O’Neal ◽

J’Neka Claxton ◽

Richard MacLehose ◽

Lin Chen ◽

Lindsay G Bengtson ◽

...

Keyword(s):

Atrial Fibrillation ◽

Oral Anticoagulant ◽

Cox Regression ◽

Prior History ◽

Cancer Type ◽

Patients With Cancer ◽

Increased Risk ◽

History Of ◽

Reduced Risk ◽

History Of Cancer

Background: Early cardiology involvement within 90 days of atrial fibrillation (AF) diagnosis is associated with greater likelihood of oral anticoagulant use and a reduced risk of stroke. Due to variation in cardiovascular care for patients with cancer, it is possible that a similar association does not exist for AF patients with cancer. Methods: We examined the association of early cardiology involvement with oral anticoagulation use among non-valvular AF patients with history of cancer (past or active), using data from 388,045 patients (mean age=68±15 years; 59% male) from the MarketScan database (2009-2014). ICD-9 codes in any position were used to identify cancer diagnosis prior to AF diagnosis. Provider specialty and filled anticoagulant prescriptions 3 months prior to and 6 months after AF diagnosis were obtained. Poisson regression models were used to compute the probability of an oral anticoagulant prescription fill and Cox regression was used to estimate the risk of stroke and major bleeding. Results: A total of 64,016 (17%) AF patients had a prior history of cancer. Cardiology involvement was less likely to occur among patients with history of cancer than those without (relative risk=0.92, 95% confidence interval (0.91, 0.93)). Similar differences were observed for cancers of the colon (0.90 (0.88, 0.92)), lung (0.76 (0.74, 0.78)), pancreas (0.74 (0.69, 0.80)), and hematologic system (0.88 (0.87, 0.90)), while no differences were observed for breast or prostate cancers. Patients with cancer were less likely to fill prescriptions for anticoagulants (0.89 (0.88, 0.90)) than those without cancer, and similar results were observed for cancers of the colon, lung, prostate, pancreas, and hematologic system. However, patients with cancer were more likely to fill prescriptions for anticoagulants (1.48 (1.45, 1.52)) if seen by a cardiology provider, regardless of cancer type. A reduced risk of stroke (hazard ratio=0.89 (0.81, 0.99)) was observed among all cancer patients who were seen by a cardiology provider than among those who were not, without an increased risk of bleeding (1.04 (0.95, 1.13)). Conclusion: AF patients with cancer were less likely to see a cardiologist, and less likely to fill an anticoagulant prescription than AF patients without cancer. However, cardiology involvement was associated with increased anticoagulant prescription fills and reduced risk of stroke, suggesting a beneficial role for cardiology providers to improve outcomes in AF patients with history of cancer.

Download Full-text

Abstract WP226: Short Lasting Runs (<30 sec) of Atrial Fibrillation are More Commonly Observed in Ischemic Stroke Patients in Comparison to Controls

Stroke ◽

10.1161/str.47.suppl_1.wp226 ◽

2016 ◽

Vol 47 (suppl_1) ◽

Author(s):

Ethem Murat Arsava ◽

Ezgi Yetim ◽

Ugur Canpolat ◽

Necla Ozer ◽

Kudret Aytemir ◽

...

Keyword(s):

Atrial Fibrillation ◽

Ischemic Stroke ◽

Multivariate Analyses ◽

Holter Monitoring ◽

Female Gender ◽

Prior History ◽

Consecutive Series ◽

Stroke Patients ◽

Cross Sectional ◽

History Of

Background: The role of short-lasting (<30 sec) runs of atrial fibrillation (AF) in ischemic stroke pathophysiology is currently unknown. Although these non-sustained attacks are considered as a risk factor for future development of longer lasting, classical AF episodes, prior research has highlighted that associated clinical stroke features are not entirely similar between these two types of arrhythmias. In this study we determined the prevalence of short-lasting AF in stroke-free controls and compared it to a consecutive series of ischemic stroke patients. Methods: A total 235 controls, without any prior history stroke or AF, were evaluated with ECG and 24-hour Holter monitoring for the presence of <30-sec or ≥30-sec lasting AF episodes. The results were compared to a consecutive series of ischemic stroke patients without prior history of AF (n=456). Univariate and multivariate analyses were performed to determine demographic and cardiovascular factors related to <30-sec lasting AF and its association with ischemic stroke. Results: Expectedly, the frequency of newly diagnosed ≥30-sec lasting AF, detected either on ECG or Holter monitoring, was significantly higher in patients with ischemic stroke (18% vs. 2%; p<0.01). Non-sustained AF was positively related to old age (p<0.01), female gender (p=0.01) and hypertension (p<0.01) in univariate analyses. In multivariate analyses, after adjustment for demographic and cardiovascular risk factors, presence of non-sustained AF was significantly higher among both cryptogenic (OR 1.78; 95% CI 1.02-3.10) and non-cryptogenic (OR 1.84; 95% CI 1.15-2.94) stroke patients with respect to controls. Conclusion: Our study shows a higher prevalence of non-sustained AF episodes in ischemic stroke patients in comparison to controls. Whether this cross-sectional association translates into causality in terms of stroke pathophysiology will be the subject of future studies.

Download Full-text

Abstract 16884: Evaluating the Effectiveness of Atrial Fibrillation Ablation Guided by Spatiotemporal Electrogram Dispersion

Circulation ◽

10.1161/circ.142.suppl_3.16884 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Brian Liu ◽

Arismendy Nunez-Garcia ◽

Cao Tran ◽

Michael Wu

Keyword(s):

Atrial Fibrillation ◽

Atrial Tachycardia ◽

Statistical Significance ◽

Univariate Analysis ◽

External Validation ◽

Posterior Wall ◽

High Rate ◽

Single Center Experience ◽

The Mean

Introduction: Catheter ablation of atrial fibrillation (AF) guided by spatiotemporal dispersion (SD) of electrograms has been proposed as an ablation strategy to treat patients with persistent AF. However, external validation of this technique is lacking. Here we report a single center experience using ablation by SD. Hypothesis: Targeting regions with SD is associated with a high rate of termination and favorable freedom from AF among patients with persistent AF. Methods: Patients with persistent AF who underwent SD from November 2018 to January 2020 were included in this study. All patients underwent pulmonary vein isolation (PVI) in addition to targeting areas of SD. Lesions on areas of electrogram dispersion were anchored to the PVI or to mitral or posterior wall lines where appropriate. EKG, Holter, event monitors or device interrogations were obtained at 3 and 6 months to assess for arrhythmia recurrence. Results: 44 patients met the inclusion criteria and were included in the study. The patients had a mean age of 69±8 years and were 68 % male. The prevalence of comorbidities was as follows: hypertension (89%), diabetes (21%), OSA (37%) and CAD (26%). Average CHADSVASC score was 2.9±1.4, LVEF was 53±11% and left atrium (LA) diameter was 5.2±1 cm. The recurrence rate of AF at 6 months was 14% whereas the recurrence of atrial tachycardia was 20%. Acute AF termination was observed in 73% of the patients. Termination to sinus occurred in 38% of the patients and the remaining terminated to atrial tachycardia which was subsequently ablated to sinus. The mean procedure duration was 240±90 minutes. Univariate analysis showed recurrence was associated with LA diameter (r=.52; p<.001). No recurrences were observed among patients with a LA diameter < 5 cm. Termination rates were higher among patients with LA diameter < 5 cm when compared to LA diameter ≥ 5 cm. However, it did not reach statistical significance (80% vs. 60%; p=.21). Conclusions: The target of electrograms with SD during AF ablation added to PVI was associated with a high termination rate and a good freedom from AF recurrence at 6 months. The ideal candidate for this procedure may be those with LA diameter < 5 cm among persistent AF. The long-term efficacy of this technique merits further studies in larger populations.

Download Full-text

Risk Factors for Community Acquired Extended-Spectrum Β-lactamase (ESBL) Producing Enterobacteriaceae Urinary Tract Infections (UTIs)

Open Forum Infectious Diseases ◽

10.1093/ofid/ofx163.827 ◽

2017 ◽

Vol 4 (suppl_1) ◽

pp. S345-S345

Author(s):

Dheeraj Goyal ◽

Kristin Dascomb ◽

Peter S Jones ◽

Bert K Lopansri

Keyword(s):

Risk Factors ◽

Urinary Tract ◽

Urinary Catheter ◽

Univariate Analysis ◽

Prior History ◽

Factors Associated ◽

Extended Spectrum ◽

History Of ◽

Enterobacteriaceae Infections ◽

Tract Infections

Abstract Background Community-acquired extended-spectrum β-lactamase (ESBL) producing Enterobacteriaceae infections pose unique treatment challenges. Identifying risk factors associated with ESBL Enterobacteriaceae infections outside of prior colonization is important for empiric management in an era of antimicrobial stewardship. Methods We randomly selected 251 adult inpatients admitted to an Intermountain healthcare facility in Utah with an ESBL Enterobacteriaceae urinary tract infection (UTI) between January 1, 2001 and January 1, 2016. 1:1 matched controls had UTI at admission with Enterobacteriaceae but did not produce ESBL. UTI at admission was defined as urine culture positive for > 100,000 colony forming units per milliliter (cfu/mL) of Enterobacteriaceae and positive symptoms within 7 days prior or 2 days after admission. Repeated UTI was defined as more than 3 episodes of UTI within 12 months preceding index hospitalization. Cases with prior history of ESBL Enterobacteriaceae UTIs or another hospitalization three months preceding the index admission were excluded. Univariate and multiple logistic regression techniques were used to identify the risk factors associated with first episode of ESBL Enterobacteriaceae UTI at the time of hospitalization. Results In univariate analysis, history of repeated UTIs, neurogenic bladder, presence of a urinary catheter at time of admission, and prior exposure to outpatient antibiotics within past one month were found to be significantly associated with ESBL Enterobacteriaceae UTIs. When controlling for age differences, severity of illness and co-morbid conditions, history of repeated UTIs (adjusted odds ratio (AOR) 6.76, 95% confidence interval (CI) 3.60–13.41), presence of a urinary catheter at admission (AOR 2.75, 95% CI 1.25 – 6.24) and prior antibiotic exposure (AOR: 8.50, 95% CI: 3.09 – 30.13) remained significantly associated with development of new ESBL Enterobacteriaceae UTIs. Conclusion Patients in the community with urinary catheters, history of recurrent UTIs, or recent antimicrobial use can develop de novo ESBL Enterobacteriaceae UTIs. Disclosures All authors: No reported disclosures.

Download Full-text

ECG Monitoring After Cardiac Surgery

AACN Advanced Critical Care ◽

10.4037/15597768-2007-3008 ◽

2007 ◽

Vol 18 (3) ◽

pp. 294-304

Author(s):

Leslie S. Kern ◽

Marion E. McRae ◽

Marjorie Funk

Keyword(s):

Atrial Fibrillation ◽

Cardiac Surgery ◽

Preventive Therapy ◽

Cost Of Care ◽

Adverse Outcomes ◽

Postoperative Atrial Fibrillation ◽

History Of ◽

Bedside Monitor ◽

Atrial Electrogram ◽

Ventricular Activity

Atrial fibrillation is one of the most common complications after cardiac surgery and is associated with adverse outcomes such as increased mortality, neurological problems, longer hospitalizations, and increased cost of care. Major risk factors for the development of postoperative atrial fibrillation include older age and a history of atrial fibrillation. β-Blockers are the most effective preventive therapy, although sotalol and amiodarone can also be used for prophylaxis. In the postoperative period, the nurse plays an important role in the early detection of atrial fibrillation by the recording of an atrial electrogram, which is easily obtained from the bedside monitor. Because an atrial electrogram records larger atrial activity than ventricular activity, it can be invaluable in establishing the diagnosis of postoperative atrial fibrillation. Once atrial fibrillation begins, treatment can be started with either rhythm conversion or rate-controlling medications.

Download Full-text

Beat-to-Beat P-Wave Analysis Outperforms Conventional P-Wave Indices in Identifying Patients with a History of Paroxysmal Atrial Fibrillation during Sinus Rhythm

Diagnostics ◽

10.3390/diagnostics11091694 ◽

2021 ◽

Vol 11 (9) ◽

pp. 1694

Author(s):

Dimitrios Tachmatzidis ◽

Dimitrios Filos ◽

Ioanna Chouvarda ◽

Anastasios Tsarouchas ◽

Dimitrios Mouselimis ◽

...

Keyword(s):

Atrial Fibrillation ◽

Sinus Rhythm ◽

Paroxysmal Atrial Fibrillation ◽

Univariate Analysis ◽

Multivariate Logistic Regression Analysis ◽

P Wave ◽

P Value ◽

Wave Analysis ◽

P Waves ◽

History Of

Early identification of patients at risk for paroxysmal atrial fibrillation (PAF) is essential to attain optimal treatment and a favorable prognosis. We compared the performance of a beat-to-beat (B2B) P-wave analysis with that of standard P-wave indices (SPWIs) in identifying patients prone to PAF. To this end, 12-lead ECG and 10 min vectorcardiogram (VCG) recordings were obtained from 33 consecutive, antiarrhythmic therapy naïve patients, with a short history of low burden PAF, and from 56 age- and sex-matched individuals with no AF history. For both groups, SPWIs were calculated, while the VCG recordings were analyzed on a B2B basis, and the P-waves were classified to a primary or secondary morphology. Wavelet transform was used to further analyze P-wave signals of main morphology. Univariate analysis revealed that none of the SPWIs performed acceptably in PAF detection, while five B2B features reached an AUC above 0.7. Moreover, multivariate logistic regression analysis was used to develop two classifiers—one based on B2B analysis derived features and one using only SPWIs. The B2B classifier was found to be superior to SPWIs classifier; B2B AUC: 0.849 (0.754–0.917) vs. SPWIs AUC: 0.721 (0.613–0.813), p value: 0.041. Therefore, in the studied population, the proposed B2B P-wave analysis outperforms SPWIs in detecting patients with PAF while in sinus rhythm. This can be used in further clinical trials regarding the prognosis of such patients.

Download Full-text

Prevention of stroke in chronic andrecurrent atrial fibrillation

Australian Health Review ◽

10.1071/ah010061 ◽

2001 ◽

Vol 24 (3) ◽

pp. 61 ◽

Cited By ~ 4

Author(s):

Anne-Maree Kelly ◽

Debra Kerr ◽

Ruth Hew

Keyword(s):

Atrial Fibrillation ◽

High Risk ◽

American Heart ◽

Anticoagulation Therapy ◽

Heart Association ◽

Chronic Atrial Fibrillation ◽

Prior History ◽

Demographic Information ◽

Thromboembolic Stroke ◽

History Of

The objective was to determine the proportion of patients presenting to the Emergency Department (ED) in atrialfibrillation (AF) who are at high risk of thromboembolic stroke as defined by the American Heart Association andwho might benefit from anticoagulation therapy.We enrolled all patients identified as having AF between 28th June 1999 and 26th March 2000. Data collectedincluded demographic information, presenting complaint, discharge diagnosis, risk factors for thromboembolic stroke,contraindications to anticoagulation (as defined by the Stroke Prevention in AF Investigators), admission anddischarge medications, and cardiac rhythm on presentation and at discharge.193 patients were identified within the study period. Two patient histories were not available for review. 121 patientshad a prior history of AF. Of these, 65 patients were at high risk for thromboembolic stroke and had no contra-indicationto anticoagulation therapy. 43 (66%) were on Warfarin at presentation but 14 (22%) were on Aspirinand 8 (12%) were on neither.34% of patients with chronic atrial fibrillation presenting to the ED, at high risk of thromboembolic stroke andwithout contra-indication to anticoagulation, were not anticoagulated on presentation. ED attendance provides anopportunity for intervention for the prevention of stroke in this group.

Download Full-text

THE MAGNETIC RESONANCE IMAGING OF THE LUMBAR SPINE IN OUT-PATIENTS WITH LOW BACK PAIN

Journal of Musculoskeletal Research ◽

10.1142/s0218957701000611 ◽

2001 ◽

Vol 05 (04) ◽

pp. 261-267 ◽

Cited By ~ 1

Author(s):

BOHUA CHEN ◽

STEVE LAVENDER ◽

GUNNAR B. J. ANDERSSON

Keyword(s):

Logistic Regression ◽

Medical Center ◽

Lumbar Disc ◽

Statistical Significance ◽

White Collar ◽

Individual Characteristics ◽

Blue Collar ◽

Prior History ◽

Spine Pathology ◽

History Of

This paper aims to estimate the prevalence rates of MRI change in LBP out-patients and to determine the relationship between abnormalities in an MRI and personal and occupational factors. The MRI records were obtained from 200 out-patients with LBP (114 males and 86 females) who received a diagnostic MRI at St. Luke's Medical Center. The mean and standard deviation of this sample's age were 43.8 years and 14.8 years, respectively. Based on the MRI, each lumbar disc was scored as normal or degenerated. Bulging and herniated were also recorded. Each patient completed a short questionnaire that included the measures of height, weight, age, and present occupation and any history of "heavy manual labor". Occupations were grouped into white collar sedentary, white collar professional, blue collar exposed to prolonged sitting and vibration, blue collar exposed to heavy, unemployed or retired, and homemaker. Chi-square tests were used to determine the statistical significance of these trends. A multiple logistic regression was used to develop a predictive model of spine pathology based on a subject's individual characteristics and occupational classification. Normal discs were found in 26% of the patients and degenerated discs in 47.5%. There were bulging/herniated disks in 26.5%. In men who were younger than 29 years, 50% had herniated disks, and 50% were normal. Three fourth of the women in the same age group showed normal discs. Forty-three percent of the subjects reported a history of performing heavy labor. Using the logistic regression model there were two variables predictive of observable MRI pathology: age and prior history of heavy labor. The analysis indicated that an older individual who had a history and heavy labor was more likely to show one or more pathological model discs in an MRI scan.

Download Full-text

Abstract 18516: Regional Dysfunction of Left Atrial Appendage and its Association with Stroke in Atrial Fibrillation

Circulation ◽

10.1161/circ.130.suppl_2.18516 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Abdullah A Alissa ◽

Yuko Inoue ◽

Jochen Cammin ◽

Qiulin Tang ◽

Elliot Fishman ◽

...

Keyword(s):

Atrial Fibrillation ◽

Left Atrial ◽

Left Atrial Appendage ◽

Atrial Appendage ◽

Control Group ◽

Prior History ◽

Area Change ◽

Increased Risk ◽

History Of ◽

Regional Dysfunction

Background: Atrial Fibrillation (AF) is associated with an increased risk of cardioembolic stroke. Previous studies demonstrate that the Left atrial appendage (LAA) is the most common site of intracardiac thrombus, and the LAA morphology alone may determine the risk of stroke. We aimed to determine the association between LAA regional dysfunction using novel, noninvasive, image-based motion-estimation CT (iME) and prior history of stroke in patients with AF. Methods: Among the patients with history of AF referred for ablation who underwent pre-ablation CT with retrospective ECG gating, we identified 18 patients with a prior history of stroke or TIA, and 18 age- and gender-matched controls. The patients in AF at the time of CT were excluded. Four-dimensional motion vector field was estimated from reconstructed CT images using iME at every 5% RR interval. To assess myocardial deformation, area change ratio and area change rate were calculated over the endocardial surface of the LA and LAA. Univariate and multivariate comparisons were made by using binary logistic regression model. Results: A total of 36 patients (mean age 67.6 ± 8.1 years, 66.7% male, 16.7% persistent AF) were included in the study. Univariate analysis showed that the LA pre-atrial contraction area change ratio and LAA maximum area change ratio were significantly lower (P= 0.02 and 0.04, respectively) in the stroke/TIA group compared to the control group. These changes remained statistically significant in multivariate analysis (P=0.03 and 0.04, respectively) after adjusting for age, sex, body mass index, LV ejection fraction, type of AF, and CHADS score. Conclusions: LAA regional dysfunction is associated with stroke/TIA in patients with AF. LAA regional dysfunction detected by iME could represent a marker for stroke and a possible therapeutic target.

Download Full-text