scholarly journals Subject-Specific Calculation of Left Atrial Appendage Blood-Borne Particle Residence Time Distribution in Atrial Fibrillation

2021 ◽  
Vol 12 ◽  
Author(s):  
Soroosh Sanatkhani ◽  
Sotirios Nedios ◽  
Prahlad G. Menon ◽  
Andreas Bollmann ◽  
Gerhard Hindricks ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Residence Time ◽  
Left Atrial ◽  
Time Distribution ◽  
Residence Time Distribution ◽  
Stroke Risk ◽  
Left Atrial Appendage ◽  
Independent Information ◽  
3D Geometry ◽  
Subject Specific

Atrial fibrillation (AF) is the most common arrhythmia that leads to thrombus formation, mostly in the left atrial appendage (LAA). The current standard of stratifying stroke risk, based on the CHA2DS2-VASc score, does not consider LAA morphology, and the clinically accepted LAA morphology-based classification is highly subjective. The aim of this study was to determine whether LAA blood-borne particle residence time distribution and the proposed quantitative index of LAA 3D geometry can add independent information to the CHA2DS2-VASc score. Data were collected from 16 AF subjects. Subject-specific measurements included left atrial (LA) and LAA 3D geometry obtained by cardiac computed tomography, cardiac output, and heart rate. We quantified 3D LAA appearance in terms of a novel LAA appearance complexity index (LAA-ACI). We employed computational fluid dynamics analysis and a systems-based approach to quantify residence time distribution and associated calculated variable (LAA mean residence time, tm) in each subject. The LAA-ACI captured the subject-specific LAA 3D geometry in terms of a single number. LAA tm varied significantly within a given LAA morphology as defined by the current subjective method and it was not simply a reflection of LAA geometry/appearance. In addition, LAA-ACI and LAA tm varied significantly for a given CHA2DS2-VASc score, indicating that these two indices of stasis are not simply a reflection of the subjects' clinical status. We conclude that LAA-ACI and LAA tm add independent information to the CHA2DS2-VASc score about stasis risk and thereby can potentially enhance its ability to stratify stroke risk in AF patients.

scholarly journals Novel stroke risk reduction in atrial fibrillation: left atrial appendage occlusion with a focus on the Watchman closure device

2017 ◽  
Vol Volume 13 ◽  
pp. 81-90 ◽  
Author(s):  
Arash Alipour ◽  
Lisette I S Wintgens ◽  
Martin J Swaans ◽  
Jippe C Balt ◽  
Benno JWM Rensing ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Risk Reduction ◽  
Left Atrial ◽  
Stroke Risk ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Closure Device ◽  
Left Atrial Appendage Occlusion

scholarly journals Left atrial appendage occlusion: an alternative to anticoagulation for stroke prevention in kidney disease

Kidney360 ◽  
2021 ◽  
pp. 10.34067/KID.0004082021
Author(s):  
Srikanth Vallurupalli ◽  
Tanya Sharma ◽  
Subhi Al'Aref ◽  
Subodh R. Devabhaktuni ◽  
Gaurav Dhar
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial ◽  
Stroke Risk ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
High Risk Population ◽  
Thromboembolic Stroke ◽  
Nonvalvular Atrial Fibrillation ◽  
Left Atrial Appendage Occlusion ◽  
Pros And Cons

Anticoagulation to reduce thromboembolic stroke risk due to nonvalvular atrial fibrillation in ESRD is associated with increased bleeding. Existing debate in ESRD centers around the pros and cons of anticoagulation. We propose percutaneous left atrial appendage occlusion as a third alternative to balance thrombosis and bleeding risks in this high risk population.

scholarly journals Addressing Stroke Risk in a Patient with CREST Syndrome and Atrial Fibrillation with Left Atrial appendage Occluder Device (WATCHMAN)

2021 ◽  
Vol 4 (1) ◽  
pp. 01-04
Author(s):  
Ali Alkhayru
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial ◽  
Stroke Risk ◽  
Left Atrial Appendage ◽  
Bleeding Risk ◽  
Atrial Appendage ◽  
Crest Syndrome ◽  
Increased Risk ◽  
Occluder Device ◽  
One Year

CREST syndrome is rare autoimmune disease causing calcinosis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly and telangiectasias. We present a case of an eighty-two year old female with CREST syndrome who presented to our clinic with atrial fibrillation and prohibitive bleeding risk. Managing stroke risk in atrial fibrillation is essential to minimize the morbidity and mortality of the condition. Those with CREST syndrome presenting with recurrent gastrointestinal bleeding may require alternatives to anticoagulation. Recently, the left atrial appendage occluder device became widely used to manage patients at increased risk for bleeding. The device provides a safe and efficacious alternative in lowering atrial fibrillation associated stroke risk. Our patient underwent uncomplicated implantation of the left atrial appendage occluder device. She was closely monitored for one year where she remained stroke free and had one minor episode of gastrointestinal hemorrhage.

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