Abstract 18804: A Comparison Between Left Appendage Morphologies on Left Appendage Flow Velocity in Patients with Atrial Fibrillation
Background: Reduction of left atrial appendage (LAA) flow velocity (FV) is a well-established prognostic factor for thrombus formation and increases the risk for stroke in patients with atrial fibrillation (AF). Recently, it has been reported that patients with chicken wing type of LAA morphology had less embolic events than other types. The aim of this study was to assess and compare the FV by variation of LAA morphologies in patients with AF.
Methods and result: We enrolled 96 consecutive patients referred to radio-frequency catheter ablation for paroxysmal AF (age 59.0 ± 10.2, 75% were male). All patients underwent contrast enhanced computed tomography (CT), and transthoracic and transesophageal echocardiography during sinus rhythm. The LAA morphology was classified into four types (chicken wing, cactus, windsock, and cauliflower) by CT images. The distribution of each LAA morphology was chicken wing (n = 12, 12.5%), cactus (n = 37, 38.5%), windsock (n = 31, 32.3%), and cauliflower (n = 16, 16.7 %), respectively. One way analysis of variance (ANOVA) revealed that there was a significant difference in FV by types of LAA morphology (chicken wing 73.7 ± 21.9 cm/sec, cactus 55.3 ± 14.1 cm/sec, windsock 61.9 ± 19.6 cm/sec, cauliflower 52.7 ± 18.1 cm/sec, P = 0.008), and post-hoc multiple comparison showed that FV in patients with chicken wing was significantly higher than that in patients with cactus, and cauliflower, but not with windsock (p = 0.012, p = 0.013, and p = 0.188 vs chicken wing, respectively). There were no significant for FV in the length, orifice area, and lobe count of LAA by the LAA morphology.
Conclusions: FV of chicken wing type is significantly higher than that of cactus and cauliflower, suggesting that an anatomical structure of LAA might effect on FV and embolic events in patient with AF.
Author Disclosures: K. Fukushima: None. K. Kato: None. K. Ejima: None. K. Fukushima: None. K. Hayashi,: None. C. Saito: None. K. Yoshida: None. K. Arai: None. T. Manaka: None. K. Ashihara: None. M. Shoda: None. N. Hagiwara: None.
- © 2014 by American Heart Association, Inc.