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Abstract Details

Measurement of Left Atrial Appendage Flow Velocity to Enhance Risk Assessment for Stroke in Atrial Fibrillation Patients
Cerebrovascular Disease and Interventional Neurology
P6 - Poster Session 6 (12:00 PM-1:00 PM)

The left atrial appendage (LAA) is a common site for clot formation in patients with atrial fibrillation (AF). Thrombus formation is a significant contributor to stroke risk in AF patients. Lower blood flow velocity in the LAA (LAA-FV) has been associated with higher risk of thrombus formation. However, little is known about the utility of LAA-FV in estimating stroke risk in conjunction with the CHA2DS2-VASc score.

To determine if left atrial appendage flow velocity can enhance stroke risk assessment in atrial fibrillation patients with or without cerebrovascular disease.

We conducted a retrospective study of AF patients undergoing catheter ablation over 4 years to identify an association between CHA2DS2-VASc score and LAA-FV in those with and without cerebrovascular disease. Primary predictive measurements were CHA2DS2-VASc score and LAA-FV, which was classified as low (LAA-FV < 40 cm/s) or normal (LAA-FV ≥ 40 cm/s). The outcome of the study was to identify if patients had cerebrovascular disease, defined as a history of stroke, TIA, or cortical brain infarction prior to ablation. Statistical analysis was performed using SPSS. Results with p < 0.05 were deemed significant.

We identified 408 patients (mean age 62.5 ± 10.3 years), and 73.5% were women. The rate of cerebrovascular disease was 9.6% (10 patients with TIA, 13 with ischemic stroke, 16 with brain infarct). In patients with cerebrovascular disease, mean CHA2DS2-VASc score was higher among those with low LAA-FV vs. normal LAA-FV (2.9 ± 1.3 vs. 1.4 ± 0.9, p = 0.009). However, in patients without cerebrovascular disease, low LAA-FV was not associated with higher CHA2DS2-VASc score (2.2 ± 1.3 vs. 2.1 ± 1.4, p = 0.934).

There appears to be discordance between CHA2DS2-VASc score and LAA-FV in AF patients without underlying cerebrovascular disease. This group of patients may benefit from LAA-FV measurement to fully assess their stroke risk.

Eric Zhou, MD (Cleveland Clinic Foundation)
Mr. Zhou has nothing to disclose.
Andrew D. Chang, MS No disclosure on file
Nikhil Panda No disclosure on file
Antony Chu No disclosure on file
Karen L. Furie, MD (RIH/Alpert Medical School of Brown Univ) The institution of Dr. Furie has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Janssen/BMS. Dr. Furie has received personal compensation in the range of $50,000-$99,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for BMJ/JNNP. The institution of Dr. Furie has received research support from NINDS.
Michael Atalay No disclosure on file
Christopher Song No disclosure on file
Shadi Yaghi, MD Dr. Yaghi has nothing to disclose.