INTRODUCTION: Catheter-directed atrial fibrillation (AF) ablation is contraindicated among patients with left atrial appendage (LAA) thrombus. The prevalence of LAA thrombus among fully anticoagulated patients undergoing AF ablation is unknown. METHODS AND RESULTS: We retrospectively evaluated the prevalence of LAA thrombus among 192 consecutive patients undergoing AF ablation between July 2006 and January 2009. Seven of 192 patients (3.6%) had evidence of thrombus on transesophageal echocardiogram (TEE) despite being fully anticoagulated on warfarin (international normalized ratio [INR] 2-3) for 4 consecutive weeks prior to echocardiogram. Univariate analysis demonstrated that structural heart disease, large left atrial dimension, and number of AF ablations were associated with thrombus. Three patients with thrombus had paroxysmal AF with normal LV function. CONCLUSION: Despite full anticoagulation, 3.6% of patients undergoing AF ablation had LAA thrombus. We recommend that all patients, regardless of LV function or left atrial size, should undergo preprocedural TEE to exclude the presence of LAA thrombus.
INTRODUCTION: Catheter-directed atrial fibrillation (AF) ablation is contraindicated among patients with left atrial appendage (LAA) thrombus. The prevalence of LAA thrombus among fully anticoagulated patients undergoing AF ablation is unknown. METHODS AND RESULTS: We retrospectively evaluated the prevalence of LAA thrombus among 192 consecutive patients undergoing AF ablation between July 2006 and January 2009. Seven of 192 patients (3.6%) had evidence of thrombus on transesophageal echocardiogram (TEE) despite being fully anticoagulated on warfarin (international normalized ratio [INR] 2-3) for 4 consecutive weeks prior to echocardiogram. Univariate analysis demonstrated that structural heart disease, large left atrial dimension, and number of AF ablations were associated with thrombus. Three patients with thrombus had paroxysmal AF with normal LV function. CONCLUSION: Despite full anticoagulation, 3.6% of patients undergoing AF ablation had LAA thrombus. We recommend that all patients, regardless of LV function or left atrial size, should undergo preprocedural TEE to exclude the presence of LAA thrombus.
Authors: Dominik Nelles; Moritz Lambers; Myriam Schafigh; Pedro Morais; Robert Schueler; Vivian Vij; Vedat Tiyerili; Marcel Weber; Jan Wilko Schrickel; Georg Nickenig; Christoph Hammerstingl; Alexander Sedaghat Journal: Clin Res Cardiol Date: 2020-04-19 Impact factor: 5.460
Authors: Marion Ferner; Daniel Wachtlin; Torsten Konrad; Oliver Deuster; Thomas Meinertz; Stephan von Bardeleben; Thomas Münzel; Monika Seibert-Grafe; Günter Breithardt; Thomas Rostock Journal: Clin Res Cardiol Date: 2015-06-25 Impact factor: 5.460
Authors: Neil Herring; Stephen P Page; Mohammed Ahmed; Melanie R Burg; Ross J Hunter; Mark J Earley; Simon C Sporton; James D Newton; Nikant K Sabharwal; Saul G Myerson; Yaver Bashir; Tim R Betts; Richard J Schilling; Kim Rajappan Journal: J Atr Fibrillation Date: 2013-04-06
Authors: Amish N Raval; Joaquin E Cigarroa; Mina K Chung; Larry J Diaz-Sandoval; Deborah Diercks; Jonathan P Piccini; Hee Soo Jung; Jeffrey B Washam; Babu G Welch; Allyson R Zazulia; Sean P Collins Journal: Circulation Date: 2017-02-06 Impact factor: 29.690
Authors: Benjamin A Steinberg; Bradley G Hammill; James P Daubert; Tristram D Bahnson; Pamela S Douglas; Laura G Qualls; Sean D Pokorney; Hugh Calkins; Lesley H Curtis; Jonathan P Piccini Journal: Heart Date: 2014-07-31 Impact factor: 5.994
Authors: F Zoppo; G Brandolino; A Berton; N Frigato; M Michieletto; A Zanocco; F Zerbo; E Bacchiega; A Lupo; E Bertaglia Journal: J Interv Card Electrophysiol Date: 2012-08-07 Impact factor: 1.900