Atrial thrombi in elective patients considered for atrial fibrillation rhythm control: Risk factors and prognostic value

Marcella Cabral Caires; Roberto Muniz Ferreira; Thaís Fonseca Rodrigues; David Hong Kang; Lúcia Helena Alvares Salis; Nelson Albuquerque de Souza E Silva

doi:10.1016/j.ihj.2021.01.020

Atrial thrombi in elective patients considered for atrial fibrillation rhythm control: Risk factors and prognostic value

Indian Heart J. 2021 Mar-Apr;73(2):228-230. doi: 10.1016/j.ihj.2021.01.020. Epub 2021 Jan 29.

Authors

Marcella Cabral Caires¹, Roberto Muniz Ferreira², Thaís Fonseca Rodrigues³, David Hong Kang³, Lúcia Helena Alvares Salis³, Nelson Albuquerque de Souza E Silva³

Affiliations

¹ Federal University of Rio de Janeiro, Edson Saad Heart Institute, Rua Rodolpho Paulo Rocco 255, Ilha Do Fundão, Rio de Janeiro, RJ, 21941-913, Brazil; Samaritano Hospital, Cardiology Department, Rua Bambina 98, Botafogo, Rio de Janeiro, RJ, 22251-050, Brazil.
² Federal University of Rio de Janeiro, Edson Saad Heart Institute, Rua Rodolpho Paulo Rocco 255, Ilha Do Fundão, Rio de Janeiro, RJ, 21941-913, Brazil; Samaritano Hospital, Cardiology Department, Rua Bambina 98, Botafogo, Rio de Janeiro, RJ, 22251-050, Brazil. Electronic address: betomf@terra.com.br.
³ Federal University of Rio de Janeiro, Edson Saad Heart Institute, Rua Rodolpho Paulo Rocco 255, Ilha Do Fundão, Rio de Janeiro, RJ, 21941-913, Brazil.

Abstract

The prognostic value of atrial thrombi (AT) among elective patients with atrial fibrillation (AF) referred for a rhythm control strategy is unclear. In this study, clinical variables were correlated with the presence of AT and long term survival among 205 patients submitted to transesophageal echocardiography before elective AF cardioversion or ablation. Atrial thrombi were present in 7.8% of cases and were significantly associated with reduced survival. Obesity was the only independent clinical predictor of AT [OR 4.27 (1.15-15.79), p = 0.03]. In patients with AF, AT appear to be associated with adverse outcomes, possibly indicating more advanced atrial cardiomyopathy.

Keywords: Atrial fibrillation; Prognosis; Risk factors.

MeSH terms

Atrial Fibrillation* / complications
Atrial Fibrillation* / diagnosis
Atrial Fibrillation* / epidemiology
Echocardiography, Transesophageal
Electric Countershock
Humans
Prognosis
Risk Factors
Thromboembolism*
Thrombosis* / diagnosis
Thrombosis* / epidemiology
Thrombosis* / etiology