The majority of embolisms associated with atrial fibrillation (AF) are from the left atrial appendage (LAA). To treat the existing thrombus, warfarin and novel anticoagulants have been used. However, there has been no clinical information regarding the difference of the effects of congealing the fibrinogenolysis system among these oral anticoagulants. Here, we report a case of persistent AF, in...

The gross anatomy of the cardiac lymphatic system draining the left ventricle was studied in 15 Yucatan minipigs and 2 regular swine. The findings confirm that the drainage pathways are similar to those of man and dog. After a coloring marker is injected near the apex of the left ventricle, one or more lymphatics are seen to ascend towards the left atrial appendage. Where there is more than one...

OBJECTIVE To evaluate the role of haemostatic and haemodynamic variables in left atrial thrombosis in non-rheumatic atrial fibrillation. DESIGN Case-control study. SUBJECTS One hundred and nine patients with non-rheumatic atrial fibrillation. INTERVENTIONS Peak blood velocity measured at three sites in the left atrium. Venous blood sampled for coagulant proteins and markers of haemostatic...

BACKGROUND Puncture of the atrial appendage may provide access to the pericardial space. The aim of this study was to evaluate the feasibility of epicardial mapping and ablation through an endocardial transatrial access in a swine model. METHODS AND RESULTS An 8-F Mullins sheath was used to perforate the right (n=16) or left (n=1) atrial appendage in 17 pigs (median weight, 27.5 kg; first and...

BACKGROUND In patients with atrial fibrillation (AF), most thrombus forms in the left atrial appendage (LAA). However, the relation of LAA morphology with LAA thrombus is unknown. METHODS AND RESULTS We prospectively enrolled 633 consecutive patients who were candidates for catheter ablation for symptomatic drug-resistant AF. Transesophageal echocardiography (TEE) was performed to assess LAA ...

Chronic atrial fibrillation (AF) is a complication associated with the dilated atria of patients with valvular heart disease and contributes to worsened pathology. We examined microRNA (miRNA) expression profiles in right and left atrial appendage tissue from valvular heart disease (VHD) patients. Right atrial (RA) appendage from patients undergoing coronary artery bypass grafting and left atri...

The left atrium (LA) and its appendage are common sites for the formation of thrombi in patientswithmitral stenosis and atrial fibrillation due to the stasis of blood or a poorly contracting LA. The left atrial thrombus may break into several smaller pieces forming free-floating masses, leading to catastrophic embolic events such as a stroke, systemic embolization, and total or partial obstruct...

BACKGROUND Thromboembolism due to atrial fibrillation (AF) is a frequent cause of stroke. More than 90% of thrombi in AF form in the left atrial appendage (LAA). Obliteration of the appendage may prevent embolic complications. METHODS AND RESULTS We evaluated the feasibility and safety of implanting a novel device for percutaneous left atrial appendage transcatheter occlusion (PLAATO). LAA oc...

Congenital intrapericardial aneurysmal dilatation of the left atrial appendage is a rare but correctable lesion. One such patient who underwent aneurysmectomy is described, and the literature is reviewed.

Atrial fibrillation, a chronic and highly morbid cardiovascular condition which affects over 33 million people worldwide, can be broadly categorized as valvular vs non-valvular in etiology. However, definitions of valvular atrial fibrillation have varied widely in the literature, and there is no clear consensus definition to date. Historically, patients with atrial fibrillation in the setting o...