Key result
Left atrial septal pouch shows no link to prior stroke in AF patients.
Why the study?
It is debatable whether the coexistence of an atrial septal pouch and AF increases the risk of stroke.
Does the presence of a left atrial septal pouch increase the risk of ischemic stroke in patients with atrial fibrillation?
Case-Control (n=145)
Does the presence of a left atrial septal pouch increase the risk of ischemic stroke in patients with atrial fibrillation?
Absolute Event Rate: 33.8% vs 42.9%
p-value: p=0.265
The presence of a left atrial septal pouch is not associated with an increased risk of ischemic stroke in patients with atrial fibrillation, suggesting it does not improve stroke risk stratification.
Left atrial septal pouch does not appear tied to stroke history in AF; leaves open its role in risk stratification pending prospective data.
PURPOSE: The atrial septal pouch is an anatomic variant of the interatrial septum caused by incomplete fusion of the septum primum and secundum. It is debatable whether coexistence of septal pouch and atrial fibrillation (AF) increases the risk of stroke. Thus, the aim of the study was to evaluate the coexistence of left atrial septal pouch (LASP) and AF in patients with a history of stroke in comparison with those without an earlier history of stroke. MATERIALS AND METHODS: We analyzed 145 patients with AF (68 in the study group, 77 in the control group). The study group consisted of patients with previous stroke and AF; control group consisted of patients scheduled for AF ablation. All patients underwent computed tomography with the assessment of atrial septum morphology and presence of LASP. The study was a subanalysis of the ASSAM (AssesSment of the left atrial appendage morphoLogy in patients aAfter ischaeMic Stroke) study. RESULTS: The prevalence of LASP in the entire group was 38.6%. There were no significant differences in the prevalence of LASP between the study and control groups (33.8% vs. 42.9%, P=0.265). Mean longitudinal and transverse dimensions of LASP were 9.34±3.27 and 2.4±0.6 mm, respectively, and there was no significant difference between the study and controls. Patients from the stroke group were older (P<0.0001), had a higher CHA2DS2-VASc score (5.41±1.93 vs. 1.62±1.46, P<0.0001) compared with controls. CONCLUSIONS: Presence of LASP is not more prevalent in patients with a history of stroke. Additional information on the presence of LASP do not improve accuracy of risk stratification for stroke in patients with AF.
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A 2021 study conducted a case-control in Atrial fibrillation (n=145). Left atrial septal pouch (LASP) vs. Absence of left atrial septal pouch was evaluated on Prevalence of left atrial septal pouch (p=0.265). The presence of a left atrial septal pouch was not significantly more prevalent in atrial fibrillation patients with a history of stroke compared to those without (33.8% vs. 42.9%, P=0.265).
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