Pacing and clinical electrophysiology : PACE · 2026
Left Atrial Appendage Thrombus/Sludge and Flow Velocity in Patients With Atrial Fibrillation and Low CHA2DS2-VASc Scores.
СтатьяОбзорНазвание и аннотация: Перевод в очереди
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Cui Jing, He Liu, Guo Xue-Yuan, Li Song-Nan, Tang Ri-Bo, Sang Cai-Hua, Long De-Yong, Du Xin, Dong Jian-Zeng, Ma Chang-Sheng
Аннотация
BACKGROUND: Nonvalvular atrial fibrillation (NVAF) patients with low CHA2DS2-VASc scores still have a risk of atrial thrombus formation. This study aims to identify these patients' risk factors for intracardiac thrombus or sludge.
METHODS: We conducted a retrospective study of 919 consecutive hospitalized NVAF or atrial flutter patients with a CHA2DS2-Vas score ≤ 1 (male) and ≤ 2 (female) who underwent transesophageal echocardiogram (TEE) before catheter ablation at Beijing An Zhen Hospital from November 2016 to December 2017. We collected the clinical and echocardiographic characteristics of the patients.
RESULTS: Excluding seven patients with hypertrophic cardiomyopathy, 919 patients, including 17 identified left atrial appendage (LAA) thrombus/sludge and 902 without LAA thrombus/sludge, were included. Among 17 patients with LAA thrombus/sludge, 16 (94.1%) had non-paroxysmal AF. A subgroup analysis was conducted in 403 non-paroxysmal atrial fibrillation (AF) patients. 87.8% had spontaneous echo contrast (SEC), 59.3% had severe or more severe SEC, and 4.0% had thrombus/sludge. In the multivariable model, female (odds ratio [OR] 4.612, 95% [CI] 1.454-14.627, p = 0.009) and LA diameter ≥ 45 mm (OR 13.340, [CI] 3.601, 49.415, p < 0.001) remained significantly independently associated with LAA thrombus/sludge.
CONCLUSION: Among patients with NVAF and CHA2DS2-VASc scores ≤ 1 (male) and ≤ 2 (female), those non-paroxysmal AF patients who were female and had an LA ≥ 45 mm still had a risk of LAA thrombus/sludge formation.
METHODS: We conducted a retrospective study of 919 consecutive hospitalized NVAF or atrial flutter patients with a CHA2DS2-Vas score ≤ 1 (male) and ≤ 2 (female) who underwent transesophageal echocardiogram (TEE) before catheter ablation at Beijing An Zhen Hospital from November 2016 to December 2017. We collected the clinical and echocardiographic characteristics of the patients.
RESULTS: Excluding seven patients with hypertrophic cardiomyopathy, 919 patients, including 17 identified left atrial appendage (LAA) thrombus/sludge and 902 without LAA thrombus/sludge, were included. Among 17 patients with LAA thrombus/sludge, 16 (94.1%) had non-paroxysmal AF. A subgroup analysis was conducted in 403 non-paroxysmal atrial fibrillation (AF) patients. 87.8% had spontaneous echo contrast (SEC), 59.3% had severe or more severe SEC, and 4.0% had thrombus/sludge. In the multivariable model, female (odds ratio [OR] 4.612, 95% [CI] 1.454-14.627, p = 0.009) and LA diameter ≥ 45 mm (OR 13.340, [CI] 3.601, 49.415, p < 0.001) remained significantly independently associated with LAA thrombus/sludge.
CONCLUSION: Among patients with NVAF and CHA2DS2-VASc scores ≤ 1 (male) and ≤ 2 (female), those non-paroxysmal AF patients who were female and had an LA ≥ 45 mm still had a risk of LAA thrombus/sludge formation.