Different influence of cardiac hemodynamics on thromboembolic events in patients with paroxysmal and non-paroxysmal atrial fibrillation

Yun Gi Kim, Jaemin Shim, Ki Yung Boo, Do Young Kim, Suk Kyu Oh, Kwang No Lee, Jong Choi, Young Hoon Kim

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Blood stasis in left atrium (LA) or LA appendage (LAA) is thought to be the main cause of thrombus formation and systemic embolism in atrial fibrillation (AF) patients. Paroxysmal and non-paroxysmal AF differ significantly in various aspects. Impact of cardiac hemodynamics on systemic embolism might also differ between the 2 distinct AF entities. This study was performed to evaluate the influence of cardiac hemodynamics on systemic embolism in both paroxysmal and non-paroxysmal AF. Consecutive AF patients undergoing radiofrequency catheter ablation (RFCA) in Korea University Medical Center Anam Hospital between June 1998 and February 2018 were analyzed. Among 2,801 patients who underwent first-time RFCA, a total of 231 patients had either previous ischemic stroke, transient ischemic attack, or arterial embolism. In paroxysmal AF, LA diameter, LA volume (measured with magnetic resonance imaging), left ventricular (LV) ejection fraction, E/e’, LAA flow velocity, and prevalence of spontaneous echocontrast (SEC) and dense SEC were significantly different between patients with and without thromboembolic events. However, only E/e’ was different between patients with and without thromboembolic events in non-paroxysmal AF. The influence of LA diameter, LA volume, LV EF, LAA flow velocity, and dense SEC on thromboembolic events was significantly moderated by the type of AF. In conclusion, paroxysmal and non-paroxysmal AF might have a different mechanism responsible for thrombus formation and consequent embolic events. Relative contribution of hemodynamic parameters and other factors such as atrial myopathy to thromboembolic events in paroxysmal versus non-paroxysmal AF needs further evaluation.

Original languageEnglish
Article numbere0214743
JournalPLoS ONE
Volume14
Issue number3
DOIs
Publication statusPublished - 2019 Mar 1

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Hemodynamics
hemodynamics
Atrial Fibrillation
Catheters
Ablation
Flow velocity
Heart Atria
embolism
Embolism
Magnetic resonance
appendages
Blood
Catheter Ablation
Imaging techniques
catheters
Thrombosis
atrial fibrillation
Atrial Appendage
muscular diseases
Transient Ischemic Attack

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

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Different influence of cardiac hemodynamics on thromboembolic events in patients with paroxysmal and non-paroxysmal atrial fibrillation. / Kim, Yun Gi; Shim, Jaemin; Boo, Ki Yung; Kim, Do Young; Oh, Suk Kyu; Lee, Kwang No; Choi, Jong; Kim, Young Hoon.

In: PLoS ONE, Vol. 14, No. 3, e0214743, 01.03.2019.

Research output: Contribution to journalArticle

Kim, Yun Gi ; Shim, Jaemin ; Boo, Ki Yung ; Kim, Do Young ; Oh, Suk Kyu ; Lee, Kwang No ; Choi, Jong ; Kim, Young Hoon. / Different influence of cardiac hemodynamics on thromboembolic events in patients with paroxysmal and non-paroxysmal atrial fibrillation. In: PLoS ONE. 2019 ; Vol. 14, No. 3.
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