Clinical Characteristics of Non-Valvular Atrial Fibrillation Patients With a Large Left Atrial Appendage Ostium-Limiting Percutaneous Closure

Background: The left atrial appendage (LAA) is a therapeutic target for preventing cardioembolic stroke in patients with non-valvular atrial fibrillation (NVAF). A large LAA ostium limits percutaneous LAA closure. This study investigated the characteristics and factors associated with a large LAA os...

Full description

Saved in:
Bibliographic Details
Published in:Circulation Journal 2022/07/25, Vol.86(8), pp.1263-1272
Main Authors: Machino-Ohtsuka, Tomoko, Nakagawa, Daishi, Albakaa, Noor K., Nakatsukasa, Tomofumi, Kawamatsu, Naoto, Sato, Kimi, Yamamoto, Masayoshi, Yamasaki, Hiro, Ishizu, Tomoko, Ieda, Masaki
Format: Article
Language:English
Subjects:
Atrial fibrillation
Echocardiography
LAA closure
Left atrial appendage (LAA)
Stroke
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background: The left atrial appendage (LAA) is a therapeutic target for preventing cardioembolic stroke in patients with non-valvular atrial fibrillation (NVAF). A large LAA ostium limits percutaneous LAA closure. This study investigated the characteristics and factors associated with a large LAA ostium in Japanese patients with NVAF.Methods and Results: In 1,102 NVAF patients, the maximum LAA diameter was measured using transesophageal echocardiography (TEE). A large LAA ostium was defined by a maximum diameter of >30 mm. Forty-four participants underwent repeated TEEs, and changes in LAA size under lasting AF were assessed. A large LAA ostium was observed in 3.1% of all participants and 8.9% of patients with long-standing persistent AF (LSAF). The large LAA group had greater CHA2DS2-VASc (P=0.024) and HAS-BLED scores (P=0.046) and a higher prevalence of LAA thrombus (P=0.004) than did the normal LAA group. LSAF, moderate or severe mitral regurgitation, left atrial volume ≥42 mL/m2, E/E’ ratio ≥9.5, and left ventricular mass ≥85 mg/m2were independently associated with a large LAA ostium (P
ISSN:1346-9843
1347-4820
1347-4820
DOI:10.1253/circj.CJ-22-0053