Malignant left atrial appendage morphology and embolization risk in atrial fibrillation
نویسندگان
چکیده
The risk of stroke is increased 4to 5-fold in patients with atrial fibrillation (AF). Predicting this risk is a significant clinical challenge. Despite the knowledge that most thrombi leading to cerebral embolization arise in the left atrial appendage (LAA), physicians today rely heavily on clinical predictors (CHADS2 [congestive heart failure, hypertension, age Z75 y, diabetes mellitus, and prior stroke/transient ischemic attack/thromboembolism] and CHA2DS2-VASc [congestive heart failure, hypertension, age Z75 y, diabetes mellitus, and prior stroke/transient ischemic attack/thromboembolism, vascular disease, age 65–74 y, sex category] algorithms) to stratify patients and anticoagulate accordingly. None of these clinical predictors include factors related to the LAA or its anatomic or hemodynamic characteristics. Recent studies have attempted to identify specific features in LAA morphology that may predispose to thromboembolism. Here we present 2 extreme cases of recurrent thromboembolism in AF patients with similar LAA morphologies that may have contributed to local thrombogenesis and subsequent embolization.
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عنوان ژورنال:
دوره 1 شماره
صفحات -
تاریخ انتشار 2015