Abstract 6979: Thromboembolic Risk of Movable Ball Type Left Atrial Appendage Thrombi in Patients with Atrial Fibrillation Under Widespread Use of Anticoagulant Therapy

Abstract

Background: Left atrial appendage thrombi (LAAT), especially movable ball type LAAT, have been reported to be high-risk for thromboembolic events in patients with atrial fibrillation (AF). However, thromboembolic risk of the movable ball type LAAT under widespread use of anticoagulant therapy remains unclear. Methods: We retrospectively studied 71 LAAT patients taking anticoagulants out of 1508 consecutive patients who underwent t transesophageal echocardiography (TEE) prior to cardioversion or catheter ablation for AF. Patients with significant valvular disease and coagulation disorder were excluded. Clinical data, blood sample, and transthoracic echocardiography were evaluated at the time of TEE. The LAAT were classified into movable ball, fixed ball and mountain type LAAT by three independent observers. Results: Ten of 71 LAAT patients showed movable ball type LAAT and 14 patients had fixed ball type LAAT. During follow-up (39±33 months), one patient underwent emergency thrombectomy, 5 patients developed thromboembolic event, and 12 patients died. There were no differences in clinical data, blood sample data, transthoracic echocardiographic parameters, thrombectomy/thromboembolic event rate, and survival rate among types of LAAT (Figure). Conclusion: Thromboembolic risk of the movable ball type LAAT is the same as fixed type LAAT, in patients with atrial fibrillation under widespread use of anticoagulant therapy.