Transesophageal Echocardiographic Predictors of Strokein Patients with Paroxysmal Atrial Fibrillation

Abstract

Objective The left atrial appendage is the most source of thrombus formation in atrial fibrillation. The aim of this study was to find out left atrial appendage functions in paroxysmal atrial fibrillation patients with or without stroke.Materials and MethodsThis retrospective study included 74 paroxysmal atrial fibrillation patients who were performed transesophageal echocardiography for evaluation of stroke or who had suspicion doubt of atrial septal defect and patent foramen ovale. All patients had undergone 24 hours electrocardiography Holter recorder, 2-dimensional echocardiography, transesophageal echocardiography.Results There are no differences between the groups for diabetes, hypertension, smoking, hyperlipidemia and creatinine levels. Patients with stroke group had lower left atrial appendage filling velocity (26.81±5.03, 38.92±5.14) (p<0.001), had lower left atrial appendage contraction velocity (30.82±6.07, 46.61±7.03) (p<0.001) and had bigger left atrial appendage area (2.72±0.61, 2.43±0.45) (p=0.032) than without stroke group. Left atrial appendage contraction velocity (p=0.013) and filling velocity (p=0.045) are the independent predictors of stroke.Conclusion Our findings showed that stroke is associated with low filling velocity and low contraction velocity of left atrial appendage. Our findings suggest that these indices are independent predictors of stroke. If these results are confirmed in future studies, patients with paroxysmal atrial fibrillation without stroke and with low filling velocity and low contraction velocity of left atrial appendage should receive more medical attention, to reduce unfavorable outcomes.