Predictors of thrombosis of left atrium and its appendage before catheter ablation or cardioversion in patients with non-valvular atrial fibrillation or atrial flutter

Aim. To determine the incidence of left atrial (LA) and/or LA appendage (LAA) thrombosis in patients with non-valvular fibrillation (AF) (NAF) or flutter (AFL) on transesophageal echocardiography (TEE) before elective catheter ablation (CA) cardioversion (CV) and characterize predictors LA/LAA among indicators available routine practice cardiologists general practitioners. Material methods . In this retrospective, single-center, casecontrol study, medical records 1994 NAF AFL for period 2014-2019, who underwent TEE CA CV, were analyzed. A thrombus was detected 33 (1,6%) them. For comparison group, 167 randomly selected without thrombosis. Demographic, anamnestic clinical parameters, transthoracic data, laboratory results analyzed as potential Results. Patients older (mean age, 64,8±1,6 vs 59,4±10,8 (p=0,01), more often had persistent longstanding AF, hypertension, heart failure, enlarged LA, lower ventricular ejection fraction (LVEF) estimated glomerular filtration rate, well severe symptoms according to modified European Heart Rhythm Association (EHRA) score a higher CHA2DS2-VASc (median, 4,0 2,0; p=0,0001). Oral anticoagulants taken by 88% patients; there no significant differences presence composition anticoagulant therapy between groups. Functional class (FC) EHRA (odds ratio (OR), 5,4; 95% confidence interval (CI): 1,9814,96; p=0,001) LVEF independent (OR, 0,87; CI: 0,80-0,95; p=0,002). 3-4, OR 5,1; 2,3-11,4 (p<0,0001), <48% — 7,4; 1,2-46,7 (p=0,03). sensitivity 93,7%, specificity 71,9%, positive predictive value 50,0%, negative 87,6%; 66,7, 32,3, 31,9 91,6%, respectively. Conclusion. studied group AFL, structural disease concomitant diseases, most whom received oral anticoagulants, at CV 1,6% cases. Among practice, severity arrhythmia symptoms, assessed score,