Risk of Death and Ischemic Stroke in Patients with Atrial Arrhythmia and Thrombus or Sludge in Left Atrial Appendage at One-Year Follow-Up

Kosmalska, Katarzyna; Gilis‐Malinowska, Natasza; Rzyman, Malgorzata; Daniłowicz‐Szymanowicz, Ludmiła; Fijałkowski, Marcin

doi:10.3390/jcm11041128

Cited by 5 publications

(4 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The incidence of LAAT varies greatly owing to the patient's condition, and ranges from 1.2% to 22.6%; however, if adding LAA pre-thrombus conditions such as spontaneous echo contrast, the incidence will further increase. [16] Table 1 [16][17][18][19][20][21][22][23][24][25][26][27][28] summarizes the studies on the incidence of LAAT in AF patients. From August 2016 to December 2021, the incidence of LAAT diagnosed by TEE in AF patients at the Zhoupu hospital was 2.12% (23/1,086 cases).…”

Section: Incidence Of Laat In Patients With Afmentioning

confidence: 99%

See 1 more Smart Citation

Current Status of Left Atrial Appendage Thrombus with Atrial Fibrillation

Zhao

Zhang

2023

Cardiology Discovery

View full text Add to dashboard Cite

Cardiac thrombus in patients with atrial fibrillation (AF) is most commonly found in the left atrial appendage (LAA). The incidence of LAA thrombus ranges from 1.2% to 22.6%, with the vast variation in incidence attributed to the patient’s condition. The effective rate of anticoagulation for thrombus dissolution therapy is only 50%–60%, and long-term anticoagulation treatment increases the risk of bleeding. Direct percutaneous LAA closure in AF patients with LAA thrombus in a suitable location is another alternative treatment option. LAA resection with cardiac surgery is also an effective treatment. This review presents the development of the incidence, diagnosis, and treatment of thrombus in LAA.

show abstract

Section: Incidence Of Laat In Patients With Afmentioning

confidence: 99%

“…Kosmalska [24] 2022 267 Persistent AF patients prior to ECV Yes 91% treated with anticoagulants at least 3 weeks 21.7%…”

Section: 6%mentioning

confidence: 99%

Current Status of Left Atrial Appendage Thrombus with Atrial Fibrillation

Zhao

Zhang

2023

Cardiology Discovery

View full text Add to dashboard Cite

show abstract

“…In patients with nonvalvular atrial fibrillation (NVAF) and stroke, up to 90% of the thrombus originates from the LAA, and the stroke caused by LAA thrombus (LAAT) has a larger embolization area and a higher fatality rate than other types [ 2 , 3 ]. Left atrial spontaneous echocardiographic contrast (LASEC) and left atrial appendage sludge (LAAS) are often considered precursors of LAAT, and they also increase the risk of stroke in patients with NVAF [ 4 – 6 ]. LAAT, LASEC, and LAAS are collectively referred to as LA or LAA thrombi.…”

Section: Introductionmentioning

confidence: 99%

Construction of a Clinical Predictive Model of Left Atrial and Left Atrial Appendage Thrombi in Patients with Nonvalvular Atrial Fibrillation

Yin

Zheng

et al. 2022

Journal of Interventional Cardiology

View full text Add to dashboard Cite

Background. The purpose of this study was to investigate the risk factors of left atrial (LA) or left atrial appendage (LAA) thrombi in patients with nonvalvular atrial fibrillation (NVAF) and to establish and validate relevant predictive models. It might improve thromboembolic risk stratification in patients with NVAF. Methods. This study retrospectively included 1210 consecutive patients with NVAF undergoing transesophageal echocardiography (TEE), of whom 139 patients had thrombi in LA or in LAA. Through literature review and the ten events per variable (10EPV) principle, 13 variables were finally identified for inclusion in multivariate analysis. Models were constructed by multivariate logistic stepwise regression and least absolute shrinkage and selection operator (lasso) regression. Results. After logistic regression, five variables (AF type, age, B-type natriuretic peptide, E/e’ ratio, and left atrial diameter) were finally screened out as model 1. After Lasso regression, AF type, age, gender, B-type natriuretic peptide, E/e’ ratio, left atrial diameter, and left ventricular ejection fraction were finally screened as model 2. After comparing the two models, the simpler model 1 was finally selected. The area under the ROC curve (AUC) of the model 1 was 0.865 (95% CI: 0.838–0.892), the Hosmer–Lemeshow test = 0.898, and the AUC = 0.861 after internal validation. The clinical decision curve showed that the new clinical prediction model could achieve a net clinical benefit when the expected threshold was between 0 and 0.6. Conclusion. This study constructed a new clinical prediction model of LA or LAA thrombi, with a higher discriminative degree than the CHADS2 and CHA2DS2-VASc scoring systems (AUC: 0.865 vs. 0.643; AUC: 0.865 vs 0.652).

show abstract

“…Currently, radiofrequency catheter ablation (RFCA) has become a radical surgery for patients with AF, and thrombosis in LAA is an absolute contraindication of RFCA (Hindricks et al, 2021). Spontaneous echocardiographic contrast (SEC) represents blood flow stasis and the state before thrombosis (Wang et al, 2000); studies have demonstrated that LAA SEC in patients with AF has an equally important clinical significance as thrombus (Guo et al, 2022; Kosmalska et al, 2022).…”

Section: Introductionmentioning

confidence: 99%

Study on the correlation between false‐positive filling defect in LAA CT and LAA structure in patients with atrial fibrillation based on TEE

Guo

Dong

et al. 2022

Noninvasive Electrocardiol

View full text Add to dashboard Cite

Objective: This study aims to explore the actual meaning of "false positive filling defect" in left atrial appendage (LAA) computed tomography (CT) in patients with atrial fibrillation (AF), with transesophageal echocardiography (TEE) as the gold standard. Methods:Patients with AF undergoing cardiac CT angiography and TEE examinations for proposed radiofrequency catheter ablation between October 2020 and October 2021 were selected as the study subjects. Transesophageal echocardiography was taken as the "gold standard," and spontaneous echocardiographic contrast (SEC) and thrombus events were defined as positive events. The CT manifestations were classified into three groups (true positive, false positive, and true negative) to evaluate the differences in left atrium (LA) anterior-posterior diameter (LAAP), LA anterior wall thickness, and LAA orifice long diameter and short diameter, area, and depth between the three groups. Results:(1) There was no statistical difference in LA anterior wall thickness between the three groups (p > .05); there was a statistical difference in LAAP (only) between the true-positive group and the true-negative group (p < .05). ( 2) There was a statistical difference in LAA orifice long diameter, short diameter, and area between the true-positive group and the true-negative group as well as between the false-positive group and the true-negative group (p < .05). ( 3) There was a statistical difference in LAA depth between the true-positive group and the false-positive group as well as between the true-positive group and the true-negative group (p < .05). ( 4) The area under the receiver operator characteristic curve (AUC) of LAA depth affecting the LAA thrombus and SEC was 0.863 (confidence interval = 0.718-1.000), the sensitivity was 77.8%, and the specificity was 90.6% for predicting the occurrence of LAA thrombus and SEC in patients with nonvalvular AF (NVAF) and an LAA depth of ≥50.84 mm. Conclusions:There was a difference in LAA diameter between the TEE-based CT false-positive group and the other groups. A "CT false positive" is an objectively existing state, and CT might be able to identify the LAA hemodynamic disorder earlier than How to cite this article:

show abstract

Risk of Death and Ischemic Stroke in Patients with Atrial Arrhythmia and Thrombus or Sludge in Left Atrial Appendage at One-Year Follow-Up

Cited by 5 publications

References 32 publications

Current Status of Left Atrial Appendage Thrombus with Atrial Fibrillation

Current Status of Left Atrial Appendage Thrombus with Atrial Fibrillation

Construction of a Clinical Predictive Model of Left Atrial and Left Atrial Appendage Thrombi in Patients with Nonvalvular Atrial Fibrillation

Study on the correlation between false‐positive filling defect in LAA CT and LAA structure in patients with atrial fibrillation based on TEE

Contact Info

Product

Resources

About