Diagnostic value of TEE indexes in left atrial appendage thrombus in patients with atrial fibrillation before radiofre-quency ablation

WU Mingyue; LEI Fang; YANG Yujing

doi:10.20258/j.cnki.1006-9011.2025.01.011

Abstract：Objective To analyze the risk factors of left atrial appendage thrombus(LAAT),and to explore the application value of transesophageal echocardiography(TEE)in the diagnosis of LAAT in patients with atrial fibrillation before radiofre-quency ablation.Methods A total of 82 patients with persistent atrial fibrillation and 82 patients without atrial fibrillation were enrolled as atrial fibrillation group and control group.All underwent transthoracic echocardiography and TEE to measure and re-cord anteroposterior diameter and left-right diameter of left atrium,LAA flow emptying velocity(LAA-FEV),LAA flow filling ve-locity(LAA-FFV),left atrial appendage volume(LAA-V)and left atrial appendage ejection fraction(LAA-EF).According to TEE results,patients in atrial fibrillation group were divided into thrombus group(n=21)and non-thrombus group(n=61).The influencing factors of LAAT were analyzed by Logistics regression analysis.Results The anteroposterior diameter of left auricle,left-right diameter,auricular appendage depth,auricular appendage diameter and LAA volume in atrial fibrillation group were higher than those in control group(P<0.05).LAA-FEV,LAA-FFV and LAA-EF in atrial fibrillation group were significantly lower than those in control group,while LAA-V was significantly larger than that in control group(P<0.05).The detection rate of LAAT by TEE was 25.61%.LAA-FEV,LAA-FFV and LAA-EF in thrombus group were significantly lower than those in non-thrombus group,while LAA-V was significantly larger than that in non-thrombus group(P<0.05).The decreased LAA-FEV(OR=0.480,P=0.015),decreased LAA-FFV(OR=0.359,P=0.009),decreased LAA-EF(OR=0.420,P=0.033)and increased LAA-V(OR=2.570,P=0.013)were all risk factors of LAAT(P<0.05).Conclusion TEE has good diagnostic value for LAAT in pa-tients with atrial fibrillation.TEE can be applied to evaluate LAAT risk before radiofrequency ablation to ensure treatment safety.