LAA thrombi prevalence by TOE - Correlation with CHA2DS2-VASC score
Research type
Research Study
Full title
LAA thrombi prevalence by TOE - Correlation with CHA2DS2-VASC score
IRAS ID
166270
Contact name
Adrian Chenzbraun
Contact email
Sponsor organisation
RD+I Dept Royal Liverpool University Teaching Hospital
Duration of Study in the UK
0 years, 3 months, 1 days
Research summary
Atrial fibrillation (AF) is an increasingly common condition, especially in the elderly, with a prevalence reaching 9% in the octogenarians. Effective anticoagulation with either vitamin K antagonists (VKA) or novel anticoagulants (NOAC) significantly lowers the incidence of stroke in these patients. However, the stroke risk is not equally present in all AF patients. The CHA2DS2-VASc score is widely used and it is promoted by existing guidelines, to stratify non-valvular AF patients for stroke risk and decide whether anticoagulation is needed. The general assumption is that thromboembolic events in AF are due to left atrium (LA) or left atrial appendage (LAA) thrombi that form at these sites due to the low-flow status resulting from loss of mechanical activity by the fibrillating atria. However, the actual evidence for this direct relationship assumption is scarce and this may not be the mechanism for stroke in at least some of these patients. In fact, it is accepted that up to 25% of embolic events in AF patients are not related to left atrial thrombi.
This study aims to define the prevalence of LAT in AF patients without satisfactory anticoagulation undergoing TOE-guided cardioversion and correlate LAT presence with patients’ CHA2DS2-VASc score. A low LAT prevalence and poor correlation with CHA2DS2-VASc score would suggest that mecjanisms other than LAT my be responsible for embolic events in at least some of AF patients. Though this possibility is aknowledged, it has not been specifically investigated in the past.REC name
North West - Preston Research Ethics Committee
REC reference
15/NW/0633
Date of REC Opinion
28 Jul 2015
REC opinion
Favourable Opinion