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Left atrial appendage thrombi relate to easily accessible clinical parameters in patients undergoing atrial fibrillation transcatheter ablation: A multicenter study
- Source :
- International journal of cardiology. 241
- Publication Year :
- 2016
-
Abstract
- Background Transesophageal echocardiography (TEE) is routinely performed before atrial fibrillation (AF) transcatheter ablation to exclude the presence of left atrial (LA) or LA appendage (LAA) thrombi. The aim of the study is to evaluate if easily accessible clinical parameters may relate to the presence of LA or LAA thrombi to identify patients who could potentially avoid TEE. Methods and results Between January 2012 and September 2014, data from 1539 consecutive patients undergoing TEE, as a work-up before AF transcatheter ablation, in six large volume centers were collected. Baseline clinical features, CHA 2 DS 2 -VASc score, transthoracic echocardiography and presence of thrombi at TEE were recorded. Exclusion criteria were valvular, hypertrophic or dilated cardiomyopathy, previous heart surgery or an ejection fraction ≤35%. Mean age was 59.6±10.4years, 1215 (78.9%) were males; 951 (62.9%) presented in sinus rhythm (SR) on admission, 324 (21.1%) had undergone at least one previous ablation and 900 (58.5%) had CHA 2 DS 2 -VASc score 0–1. Thrombi were encountered in 12 patients (0.8%). SR at TEE independently related to the absence of thrombi (OR 5.15, 95% CI 1.38–19.02, p =0.015); in addition to this, no patient with a CHA 2 DS 2 -VASc score 0–1 and SR on admission presented thrombi at TEE (specificity 100%, p =0.011). Conclusion In a selected population of patients referred for AF ablation, LA/LAA thrombi prevalence is low. No patients in SR with CHA 2 DS 2 -VASc score 0–1 presented LAA thrombi at TEE, identifying a significant subset of patients who could potentially safely be spared from pre-procedural TEE.
- Subjects :
- Adult
Male
medicine.medical_specialty
Heart Diseases
medicine.medical_treatment
Population
Catheter ablation–atrial fibrillation
LAA thrombus
Transesophageal echocardiography
030204 cardiovascular system & hematology
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Left atrial
Internal medicine
Atrial Fibrillation
medicine
Humans
Sinus rhythm
Atrial Appendage
030212 general & internal medicine
education
Aged
Catheter ablation-atrial fibrillation
education.field_of_study
Ejection fraction
business.industry
Medicine (all)
Atrial fibrillation
Dilated cardiomyopathy
Thrombosis
Middle Aged
medicine.disease
Ablation
Cardiology and Cardiovascular Medicine
Transcatheter ablation
Cardiology
Catheter Ablation
Female
Radiology
business
Echocardiography, Transesophageal
Subjects
Details
- ISSN :
- 18741754
- Volume :
- 241
- Database :
- OpenAIRE
- Journal :
- International journal of cardiology
- Accession number :
- edsair.doi.dedup.....cccaebae13586bfdab2faae0bdf2e13f