Key result
Anticoagulation dissolves ~55% of LAA thrombi in patients with AF.
Why the study?
Anticoagulation achieves left atrial appendage thrombus dissolution in only 50%–60% of cases and increases bleeding risk, prompting consideration of alternative approaches like percutaneous closure or surgical resection.
This review highlights that LAA thrombus incidence in AF varies widely, and while anticoagulation has limited efficacy for dissolution, LAA closure or surgical resection serve as viable alternative treatments.
Variable LAA thrombus incidence and modest anticoagulation efficacy in AF; leaves open percutaneous closure pending prospective trials.
Cardiac thrombus in patients with atrial fibrillation (AF) is most commonly found in the left atrial appendage (LAA). The incidence of LAA thrombus ranges from 1.2% to 22.6%, with the vast variation in incidence attributed to the patient’s condition. The effective rate of anticoagulation for thrombus dissolution therapy is only 50%–60%, and long-term anticoagulation treatment increases the risk of bleeding. Direct percutaneous LAA closure in AF patients with LAA thrombus in a suitable location is another alternative treatment option. LAA resection with cardiac surgery is also an effective treatment. This review presents the development of the incidence, diagnosis, and treatment of thrombus in LAA.
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Zhao et al. (2023) conducted a review in Atrial fibrillation with left atrial appendage thrombus. The incidence of left atrial appendage thrombus in atrial fibrillation ranges from 1.2% to 22.6%, with anticoagulation achieving a 50%-60% thrombus dissolution rate.
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