Abstract Number: PB2053
Meeting: ISTH 2020 Congress
Theme: Venous Thromboembolism and Cardioembolism » Atrial Fibrillation
Background: In patients with non-valvular atrial fibrillation (AF) left atrial thrombus (LAT) may be revealed despite of oral anticoagulants use and low risk of stroke according to modern clinical scores.
Aims: To assess frequency and predictors of LAT before catheter ablation or cardioversion in patients with non-valvular AF.
Methods: In a retrospective single center study medical records of 1994 patients with non-valvular AF subjected to the transthoracic echocardiography before catheter ablation or cardioversion between 2014 and 2019 were analyzed. LAT was revealed in 33 (1.6%) of them. For comparison 167 patients without LAT were randomly selected from the database. Logistic regression analysis was used for searching associations between different variables and LAT.
Results: Patients with LAT were older (64.8±10.6 vs 59.4±10.8 respectively; p=0.01),
more often had persistent or permanent AF, hypertension, chronic heart failure, had lower EF and eGFR and larger left atrial dimension from parasternal long-axis view. They also were more symptomatic according to modified EHRA score. All these features were univariate predictors of LAT.
CHA2DS2-VASc score was higher in patients with LAT (3.9±1.9 vs 2.3±1.6 respectively; p=0.0001) and was univariate predictor of LAT (OR 1.6, 95% CI 1.3-2.0; p=0.001). None of patient with CHA2DS2-VASc score 0 had LAT while LAT was revealed in 4 patients (all men) with CHA2DS2-VASc 1. Oral anticoagulants used 88% of patients and it was not associated with LAT.
Only EHRA score (OR 5.4; 95% CI 1.98-14.96; p=0.001) and EF (OR 0.87; 95% CI 0.80-0.95; p=0.002) were independently associated with LAT. Multivariate OR of LAT in patients with EF < 48% (cut-off value obtained at ROC analysis) was 7.4 (95% CI 1,2-46.7; p=0.03).
Conclusions: In this group of patients with non-valvular AF and low incidence of LAT symptomatic arrhythmia and reduced EF but not CHA2DS2-VASc score or oral anticoagulants use were independently associated with LAT.
To cite this abstract in AMA style:
Zaigraev I, Yavelov I, Drapkina O, Bazaeva E. Predictors of Left Atrial Thrombus before Catheter Ablation or Cardioversion in Patients with Non-Valvular Atrial Fibrillation [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/predictors-of-left-atrial-thrombus-before-catheter-ablation-or-cardioversion-in-patients-with-non-valvular-atrial-fibrillation/. Accessed October 1, 2023.« Back to ISTH 2020 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/predictors-of-left-atrial-thrombus-before-catheter-ablation-or-cardioversion-in-patients-with-non-valvular-atrial-fibrillation/