Abstract 13662: Left Atrial Appendage Morphologic Pattern Determined by Computed Tomography is a Useful Predictor of High Risk Patient for Embolism With Both Paroxysmal and Persistent Atrial Fibrillation
Background: Left atrial appendage (LAA) is the main source of left atrial thrombus that causes systemic embolism in patients with atrial fibrillation (AF). Many reports have revealed that LAA flow velocity (LAAV) evaluated by transesophageal echocardiography (TEE) is a promising predictor for LAA thrombus. We have reported that LAA morphologic pattern determined by cardiac computed tomography (CCT) is a novel predictor for LAAV in patients with AF, but it is unclear whether the LAA morphologic pattern is a useful parameter in both paroxysmal AF (PAF) and persistent AF (PerAF).
Methods: In 124 patients with AF, TEE and CCT were performed within a week. We compared the incidence of male, hypertension, diabetes mellitus and spontaneous echo contrast (SEC) evaluated by TEE and the various CCT parameters including left atrial (LA) volume, LAA volume, number of lobes, area of LAA ostium and LAA morphologic type: chicken wing type (LAA with sharp bend) and non-chicken wing type (LAA without sharp bend) between high (LAAV≧30cm/sec) and low LAAV groups in PAF and in PerAF respectively.
Results: In PAF, less LA volume and chicken wing type were predictors for high LAAV. In PerAF, younger age, less BNP level, spontaneous echo contrast, hypertension and chicken wing type were predictors for high LAAV. Chicken wing type was an only common predictor for high LAAV in both types of AF.
Conclusions: The chicken wing type can become a stable predictor of high risk patients for embolism with both paroxysmal and persistent AF.
- © 2013 by American Heart Association, Inc.