Evaluation of Atrial Thrombus Formation and Atrial Appendage Function in Patients with Pacemaker by Transesophageal Echocardiography

Alizadeh, Abolfath; Maleki, Majid; Bassiri, Hossienali; Alasti, Mohammad; Emkanjoo, Zahra; Haghjoo, Majid; Arya, Arash; Bagherzadeh, Atallah; Fazelifar, Amirfarjam; Sadr‐Ameli, Mohammad Ali

doi:10.1111/j.1540-8159.2006.00520.x

Cited by 15 publications

(7 citation statements)

References 14 publications

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“…[27] Another study demonstrated a decrease in the left atrial appendage flow velocity during ventricular pacing. [28] NSVT causes ventricular dyssynchrony and may contribute to mechanical abnormalities in the left atrial appendage, which might explain the potential for enhanced stroke/thromboembolic event. To the best of our knowledge, this study is the first investigation demonstrating that NSVT in the structural normal heart was a marker related to other stroke-causing diseases.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Outcome of Non-Sustained Ventricular Tachycardia in Structurally Normal Hearts

et al. 2016

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BackgroundThe impact of non-sustained ventricular tachycardia (NSVT) on the risk of thromboembolic event and clinical outcomes in patients without structural heart disease remains undetermined. This study aimed to evaluate the association between NSVT and clinical outcomes.MethodsThe study population of 5903 patients was culled from the “Registry of 24-hour ECG monitoring at Taipei Veterans General Hospital” (REMOTE database) between January 1, 2002 and December 31, 2004. Of that total, we enrolled 3767 patients without sustained ventricular tachycardia, structural heart disease, and permanent pacemaker. For purposes of this study, NSVT was defined as 3 or more consecutive beats arising below the atrioventricular node with an RR interval of <600 ms (>100 beats/min) and lasting < 30 seconds.ResultThere were 776 deaths, 2042 hospitalizations for any reason, 638 cardiovascular (CV)-related hospitalizations, 350 ischemic strokes, 409 transient ischemic accident (TIA), 368 new-onset heart failure (HF), and 260 new-onset atrial fibrillation (AF) with a mean follow-up duration of 10 ± 1 years. In multivariate analysis, the presence of NSVT was independently associated with death (hazard ratio [HR]: 1.362, 95% confidence interval [CI]: 1.071–1.731), CV hospitalization (HR: 1.527, 95% CI: 1.171–1.992), ischemic stroke (HR: 1.436, 95% CI: 1.014–2.032), TIA (HR 1.483, 95% CI: 1.069–2.057), and new-onset HF (HR: 1.716, 95% CI: 1.243–2.368). There was no significant association between the presence of NSVT and all-cause hospitalization or new-onset AF.ConclusionIn patients without structural heart disease, presence of NSVT on 24-hour monitoring was independently associated with death, CV hospitalization, ischemic stroke, TIA, and new onset heart failure.

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Section: Discussionmentioning

confidence: 99%

Long-Term Outcome of Non-Sustained Ventricular Tachycardia in Structurally Normal Hearts

et al. 2016

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“…In addition, Aslanabadi et al 1 observed that percutaneous transvenous mitral commissurotomy boosts the LAA function as it improved the LAA ejection fraction and emptying velocity after intervention in patients with rheumatic heart disease independent of rhythm status (NSR versus AF). In contrast, Alizadeh et al 21 showed that the implementation of pacing using VVI mode impaired the LAA function, but it did not increased the thrombus formation within the LAA. These findings designate that LAA remodeling in individuals with AF happened during the transition from sinus rhythm to fibrillation.…”

Section: Discussionmentioning

confidence: 91%

Morphologic and functional features of left atrial appendage in Iranian population: an echocardiographic study

Pourkia

Panahi

Emkanjoo

et al. 2019

J Cardiovasc Thorac Res

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Introduction: Cardioembolic events are accompanied by left atrial appendage (LAA) in patients suffering from atrial fibrillation (AF); therefore, the LAA closure is implemented as a preventive strategy. The detection of LAA morphologies and function is a paramount step before establishing the LAA closure. Herein, we sought to determine the morphologic features of the LAA in an Iranian population using echocardiographic evaluation. Methods: Seventy-two near-normal heart patients were investigated by conducting a cross-sectional study. All patients were examined using the 2-dimensional and 3-dimensional transesophageal echocardiography (2D- and 3D-TEE) method. The anatomical features and functions of LAA were examined. All images were stored and analyzed offline. Results: The patients’ mean age was 39 ± 15.5 year and 33 (45.8%) were female. The most frequent shape of LAA was wind sock. More LAA lobes was observed in patients with AF compared to those with NSR. In comparison with AF group, the NSR had higher LAA flow velocity (P < 0.01). The paroxysmal AF had greater LAA flow velocity and LAA ejection fraction in comparison with the chronic AF (39 ± 19 vs. 75 ± 22, P < 0.01; and 49±4 vs. 72±14, P < 0.003; respectively). The paroxysmal AF had smaller systolic LAA orifice area in comparison with the chronic AF (P < 0.02). Conclusion: The morphologic features of LAA in Iranian population were within the range of other studies and LAA length and orifice diameters in 2D- and 3D-TEE were consistent. In addition, AF influenced the morphologies and functions of LAA compared to sinus rhythm.

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“…One of the frequent structural changes seen in patients with ventricular cardiomyopathy is ventricular dilatation, which is known to provoke the stasis of blood flow, increased risk of thrombus formation, and embolism 25,26 . Due to the unique hemodynamic changes occurring in patients with PVCs, irregular ventricular rhythm as well as variable coupling intervals can also cause stasis of blood flow and promote thrombus formation in the left atrial appendage 27 . Moreover, the ventricular contraction from PVCs could not provide an effective cardiac output as a result of mechanical ventricular dyssynchrony.…”

Section: Discussionmentioning

confidence: 99%

Association of premature ventricular complexes and risk of ischemic stroke: A systematic review and meta‐analysis

Rujirachun

Wattanachayakul

Phichitnitikorn

et al. 2020

Clinical Cardiology

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Recent studies have suggested that patients with premature ventricular complexes (PVCs) may have a higher risk of ischemic stroke. However, the data are limited and inconclusive. We conducted a systematic review and meta‐analysis to investigate the association between PVCs and the risk of ischemic stroke. A comprehensive literature review was conducted by searching for published articles indexed in MEDLINE and EMBASE databases from inception through September 25, 2020, to identify studies that compared the risk of ischemic stroke between patients with PVCs and individuals without PVCs. Pooled risk ratio (RR) and 95% confidence interval (CI) were calculated using a random‐effect, generic inverse variance method of Dersimonian and Laird. A total of four observational studies (2 prospective and 2 retrospective cohort studies) with 42 677 participants met the eligibility criteria and were included in the meta‐analysis. We found that patients with PVCs have a significantly higher risk of ischemic stroke than individuals without PVCs with the pooled RR of 1.31 (95% CI, 1.07–1.60, I2 = 43%). From our systematic review and meta‐analysis, we found that PVCs are associated with a higher risk of ischemic stroke. Whether this association is causal and how it should be addressed in clinical practice require further investigations.

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Evaluation of Atrial Thrombus Formation and Atrial Appendage Function in Patients with Pacemaker by Transesophageal Echocardiography

Abstract: Long-term loss of AV synchrony induced by VVI pacing is associated with the impairment of LAA contraction. Thrombus formation in the LAA is not increased by VVI pacing in patients with relatively good left ventricular (LV) function and sinus rhythm.

Cited by 15 publications

References 14 publications

Long-Term Outcome of Non-Sustained Ventricular Tachycardia in Structurally Normal Hearts

Long-Term Outcome of Non-Sustained Ventricular Tachycardia in Structurally Normal Hearts

Morphologic and functional features of left atrial appendage in Iranian population: an echocardiographic study

Association of premature ventricular complexes and risk of ischemic stroke: A systematic review and meta‐analysis

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