Keywords:

Cardiol Croat

Cardiologia Croatica

Cardiol. Croat.

1848-543X 1848-5448

Croatian Cardiac Society

CC_11(10-11)_433

10.15836/ccar2016.433

Extended Abstract

Incidence and risk factors for left atrial appendage thrombus formation in patients with atrial arrhythmias scheduled for cardioversion – biannual single center experience

Stipinović

Mario

http://orcid.org/

http://orcid.org/0000-0002-9334-6371

Andreykanich

Sofiya

http://orcid.org/0000-0002-1650-4735

Jerkić

Helena

Stipinović

Bojana Aćamović

http://orcid.org/0000-0003-3257-110X

Počanić

Darko

http://orcid.org/0000-0002-1575-1902

Kranjčević

Stjepan

http://orcid.org/0000-0001-7626-3534

Kozmar

Damir

http://orcid.org/0000-0003-0585-5887

Vujanić

Darko

http://orcid.org/0000-0002-2620-3194

Dragičević

Maro

http://orcid.org/0000-0002-2592-8302

Meštrović

Ivica Premužić

http://orcid.org/0000-0003-1229-7983

Letilović

Tomislav

Clinical Hospital Merkur, Zagreb, Croatia

Address for correspondence: Mario Stipinović, Klinička bolnica Merkur, Zajčeva 19, HR-10000 Zagreb, Croatia. / Phone: +385-98-1964-133 / E-mail: mario.stipinovic@yahoo.com

112016

11 10-11 433 433 2509201610102016

2016

Croatian Cardiac Society

Keywords: atrial fibrillationthrombusleft atrial appendage

Introduction: The incidence of atrial fibrillation is increasing and it is now the most common arrhythmia in clinical practice (1). Primary therapeutic goal in patients with atrial fibrillation is to prevent thromboembolic complications (2). The aim of this study was to determine the incidence as well as risk factors for left atrial appendage (LAA) thrombus formation, detected with transesophageal echocardiography (TEE), in patients with atrial arrhythmias and planned cardioversion.

Patients and Methods: Patients with atrial arrhythmias, scheduled for synchronized cardioversion at the Department of Cardiology, Clinical Hospital Merkur in years 2014 and 2015 were studied. All patients were treated with different anticoagulation/antiaggregation protocols according to the most recent guidelines. TEE was done before every procedure. We studied various isolated risk factors known or believed to be associated with development of left atrial appendage thrombus, such as: age, sex, type of anticoagulation therapy, duration of therapy, systolic heart function and type of atrial arrhythmia. We also studied influence of coexistence of various risk factors, expressed as CHA2DS2-VASc score≥2, on LAA thrombus formation.

Results: Data from 65 patients were gathered (mean age 65.5±11.7, mean CHA2DS2-VASc score 2, 40% female, 60% male). In 14 subjects (21.5%), despite adequate anticoagulation/antiaggregation therapy, the thrombus in LAA was discovered. We found no statistically significant correlation between isolated risk factors, that were studied, and LAA thrombus formation. On the other hand statistical analysis showed correlation of LAA thrombus formation with CHA2DS2-VASc score equal or higher than 2 (p=0.017). In fact all 14 patients with thrombus (100%) had a CHA2DS2-VAScof that value.

Conclusion: There is still a significant risk of LAA thrombus in patients with atrial arrhythmias despite adequate anticoagulation therapy. LAA thrombus formation in those patients correlates with coexistence of several rather than one risk factor.

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Shen

. Atrial fibrillation. J Biomed Res. 2014 Jan;28(1):1–17. 10.7555/JBR.28.20130191

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Bradley

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Asirvatham

. Contemporary management of atrial fibrillation: update on anticoagulation and invasive management strategies. Mayo Clin Proc. 2009;84(7):643–62. 10.1016/S0025-6196(11)60754-4

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