Arrhythmias and Conduction DisturbancesNatural History of Left Atrial Spontaneous Echo Contrast in Nonrheumatic Atrial Fibrillationfn1
Section snippets
Study Population
Between January 1989 and July 1996, a total of 236 patients with chronic nonrheumatic AF underwent TEE in this hospital. Chronic nonrheumatic AF was diagnosed if there were no physical or echocardiographic evidence of rheumatic mitral stenosis or prosthetic mitral valve, and if AF was persistent for >30 days as documented by serial electrocardiography. All these patients were clinically followed up after initial TEE. To investigate the natural history of LA spontaneous echo contrast, those who
Patient Characteristics
LA spontaneous echo contrast was absent in 43 patients (group 1) and present in 34 patients (group 2) on initial TEE study. The baseline clinical and echocardiographic variables of both groups are listed in Table 1. Group 2 patients were more frequently associated with history of thromboembolism than group 1. LA thrombi were found in 8 patients of group 2 but in none of group 1 patients. Age, sex, LA dimension, left ventricular dimensions, left ventricular ejection fraction, duration of AF, and
Discussion
To understand the natural history of LA spontaneous echo contrast in patients with nonrheumatic AF is mandatory for providing the optimal preventive strategy. Although patients without LA spontaneous echo contrast were associated with a relatively low thromboembolic risk, our serial TEE study showed that 44% of these patients developed new occurrence of LA spontaneous echo contrast during a mean follow-up period of 25 months. The result may not be applicable to the general population because
Acknowledgements
We thank Huei-Chen Hsu for expert technical assistance.
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2010, Journal of the Neurological SciencesCitation Excerpt :AF is associated with the progressive decline of LA contractile function which may result in the development of blood stasis in left atrium. The blood stasis in the left atrium is known to be associated with SEC and LA/LAA thrombi [20,24,25]. LA thrombi were found 16 times more frequently in stroke patients with AF than in those without [4].
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This study was supported in part by Grant DOH84-HR-206 from the National Health Research Institute, Taipei, Taiwan, Republic of China.