scholarly journals Patent foramen ovale and left atrial appendage flow velocity predict atrial fibrillation recurrence post cryoballoon ablation

2021 ◽  
Author(s):  
Grzegorz Kiełbasa ◽  
Agnieszka Bednarek ◽  
Adam Bednarski ◽  
Agnieszka Olszanecka ◽  
Tomasz Sondej ◽  
...  
2011 ◽  
Vol 6 (1) ◽  
pp. 67
Author(s):  
Antonio L Bartorelli ◽  
Claudio Tondo ◽  
◽  

Innovative percutaneous procedures for stroke prevention have emerged in the last two decades. Transcatheter closure of the patent foramen ovale (PFO) is performed in patients who suffered a cryptogenic stroke or a transient ischaemic attach (TIA) in order to prevent recurrence of thromboembolic events. Percutaneous occlusion of the left atrial appendage (LAA) has been introduced to reduce stroke risk in patients with atrial fibrillation (AF). The role of PFO and LAA in the occurrence of cerebrovascular events and the interventional device-based therapies to occlude the PFO and LAA are discussed.


Heart Rhythm ◽  
2021 ◽  
Vol 18 (8) ◽  
pp. S126
Author(s):  
Ciro Ascione ◽  
Marco Bergonti ◽  
Valentina Catto, Stefania I. Riva ◽  
Massimo Moltrasio ◽  
Fabrizio Tundo ◽  
...  

2021 ◽  
Vol 3 (3) ◽  
pp. 508-511
Author(s):  
Omar Kousa ◽  
Toufik Mahfood-Haddad ◽  
Shantanu M. Patil ◽  
Himanshu Agarwal ◽  
Hussam Abuissa

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lei Chen ◽  
Changjiang Xu ◽  
Wensu Chen ◽  
Chaoqun Zhang

Abstract Background Thromboembolic events are the most serious complication of atrial fibrillation (AF), and the left atrial appendage (LAA) is the most important site of thrombosis in patients with AF. During the period of COVID-19, a non-invasive left atrial appendage detection method is particularly important in order to reduce the exposure of the virus. This study used CT three-dimensional reconstruction methods to explore the relationship between LAA morphology, LAA orifice area and its mechanical function in patients with non-valvular atrial fibrillation (NVAF). Methods A total of 81 consecutive patients with NVAF (36 cases of paroxysmal atrial fibrillation and 45 cases of persistent atrial fibrillation) who were planned to undergo catheter radiofrequency ablation were enrolled. All patients were examined by transthoracic echocardiography (TTE), TEE, and computed tomography angiography (CTA) before surgery. The LAA orifice area was obtained according to the images of CTA. According to the left atrial appendage morphology, it was divided into chicken wing type and non-chicken wing type. At the same time, TEE was performed to determine left atrial appendage flow velocity (LAAFV), and the relationship between the left atrial appendage orifice area and LAAFV was analyzed. Results The LAAFV in Non-chicken wing group was lower than that in Chicken wing group (36.2 ± 15.0 cm/s vs. 49.1 ± 22.0 cm/s, p-value < 0.05). In the subgroup analysis, the LAAFV in Non-chicken wing group was lower than that in Chicken wing group in the paroxysmal AF (44.0 ± 14.3 cm/s vs. 60.2 ± 22.8 cm/s, p-value < 0.05). In the persistent AF, similar results were observed (29.7 ± 12.4 cm/s vs. 40.8 ± 17.7 cm/s, p-value < 0.05). The LAAFV in persistent AF group was lower than that in paroxysmal AF group (34.6 ± 15.8 cm/s vs. 49.9 ± 20.0 cm/s, p-value < 0.001). The LAAFV was negatively correlated with left atrial dimension (R = − 0.451, p-value < 0.001), LAA orifice area (R= − 0.438, p-value < 0.001) and left ventricular mass index (LVMI) (R= − 0.624, p-value < 0.001), while it was positively correlated with LVEF (R = 0.271, p-value = 0.014). Multiple linear regression analysis showed that LAA morphology (β = − 0.335, p-value < 0.001), LAA orifice area (β = −  0.185, p-value = 0.033), AF type (β = − 0.167, p-value = 0.043) and LVMI (β = − 0.465, p-value < 0.001) were independent factors of LAAFV. Conclusions The LAA orifice area is closely related to the mechanical function of the LAA in patients with NVAF. The larger LAA orifice area and LVMI, Non-chicken wing LAA and persistent AF are independent predictors of decreased mechanical function of LAA, and these parameters might be helpful for better management of LA thrombosis.


Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Shadi Yaghi ◽  
Andrew Chang ◽  
Gian Ignacio ◽  
Erica Scher ◽  
Nikhil Panda ◽  
...  

Background and Purpose: Previously we proposed a simple classification system of the left atrial appendage (LAA) morphology, with low risk (LAA-L) defined as one lobe with an acute angle bend arising from the proximal or middle portion and high risk (LAA-H) defined as all other morphologies. We aim to determine the association between LAA morphology (using both classification systems), LAA flow velocity, and stroke rates. Methods: We analyzed consecutive patients with atrial fibrillation (AF) selected for ablation who underwent cardiac CT angiography and transesophageal echocardiogram. The primary correlates were LAA-H and non-chicken wing (NCW) LAA morphology. The primary outcome was the composite endpoint of history of ischemic stroke/TIA or non-lacunar infarct on neuroimaging. Adjusting for CHADS2Vasc score, multivariable models were used to determine associations between LAA morphology and composite outcomes. Results: We identified 379 patients; the primary endpoint occurred in 32/379 patients (8.4%). LAA-H (adjusted OR 3.63, 95% CI 1.44-9.14) and NCW LAA morphology (adjusted OR 2.52, 95% CI 1.15-5.53) were associated with the primary endpoint. LAA flow velocity ≤20 cm/s was more common in LAA-H vs. LAA-L (9.6% vs. 2.8%, p = 0.019), but not in NCW vs. CW LAA morphology (9.7% vs. 3.7%, p = 0.054). Conclusion: The LAA H/L morphological classification system may be superior to the current system in risk stratifying patients with AF and correlates better with impaired LAA flow dynamics.


2015 ◽  
Vol 24 (3) ◽  
pp. 263-268 ◽  
Author(s):  
Murat Celik ◽  
Emre Yalcinkaya ◽  
Uygar Cagdas Yuksel ◽  
Yalcin Gokoglan ◽  
Baris Bugan ◽  
...  

2019 ◽  
Vol 5 (4) ◽  
pp. 183-186 ◽  
Author(s):  
James Nadel ◽  
Rajesh Subbiah ◽  
Neil Jacobs ◽  
David W.M. Muller ◽  
Brendan Gunalingam

Sign in / Sign up

Export Citation Format

Share Document