Patrick Daly

DocwireNews

Implanting a WATCHMAN device for atrial fibrillation (AF) requires thorough knowledge of left atrial appendage (LAA) anatomy; however, &ldquo;racial differences are observed in LAA size when comparing Asians with non-Asians,&rdquo; wrote the authors of a study published in the Journal of Echocardiology. The study&rsquo;s authors, led by Miho Miyoshi, reported data on LAA orifice dimensions, as measured by multiplane transesophageal echocardiography, in a population of Japanese patients with AF.The authors&rsquo; report proposed that &ldquo;this finding should be used as a reference to understand the racial characteristics of LAA size for the WATCHMAN procedure.&rdquo;The study included a total of 170 patients with paroxysmal or persistent AF who underwent transesophageal echocardiography assessment before a catheter ablation or cardioversion procedure between September 2018 and September 2019. According to the authors, &ldquo;the maximal LAA ostial diameters were measured at multiplane angles of 0&deg;, 45&deg;, 90&deg;, and 135&deg;,&rdquo; per the WATCHMAN device recommendations.Miyoshi and colleagues reported that 71% of patients (121/160) had an LAA orifice size between 17 and 25 mm. Among patients outside of this range, 15 (8.8%) patients had LAA orifice size below 17 mm, termed undersized, and eight &ldquo;oversized&rdquo; patients (0.5%) had LAA size over 31 mm. One patient was observed with no LAA.Notably, &ldquo;LAA size was significantly larger in patients with persistent AF than in those with paroxysmal AF (23.3 &plusmn; 4.2 mm vs. 20.0 &plusmn; 3.0 mm; p &lt;0.001) and in male patients than in female patients (22.4 &plusmn; 4.2 vs. 20.9 &plusmn; 3.7 mm; p = 0.03).&rdquo; The investigators also reported that LAA dimensions were significantly correlated with CHADS2 score, left atrial value (LAV), E/e&rsquo; ratio, and left ventricular ejection fraction, while persistent AF, body mass index, and LAV were associated with LAA orifice dimension.&ldquo;This finding should be used as a reference to understand the racial characteristics of LAA size for the WATCHMAN procedure,&rdquo; the authors concluded.

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Left Atrial Appendage Orifice Size in Japanese Patients with Atrial Fibrillation

Atrial Fibrillation

Implanting a WATCHMAN device for atrial fibrillation (AF) requires thorough knowledge of left atrial appendage (LAA) anatomy; however, “racial differences are observed in ...

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