Abstract 17844: Association of Left Atrial Appendage Emptying Velocity With Type of Atrial Fibrillation

Introduction: Left atrial appendage emptying velocity (LAAev) is a surrogate for propensity of LAA thrombus and cardioembolic stroke. While atrial fibrillation (AF) is a known cause of reduced LAAev, relationship between type of AF and LAAev is unclear.

Hypothesis: Long-standing persistent/permanent (LSP) AF is associated with reduced LAAev compared to paroxysmal/persistent AF.

Methods: We searched transesophageal echocardiogram (TEE) reports of unique individuals from 2016-2022 at the University of Kansas Medical Center. LAAev was obtained from Doppler TEE images. Type of AF and other variables were extracted from medical charts. Association of AF type with LAAev was assessed using univariate and multivariate linear regressions. The multivariate model including all significant univariate predictors comprised age, sex, hypertension, coronary artery disease, peripheral arterial disease, history of venous thromboembolism, left atrial size, mitral regurgitation, left ventricular ejection fraction, rhythm during TEE, general anesthesia, eGFR, and platelet count.

Results: Our study comprised 995 patients (female 38.1%, age 71.3±12.7 yr, white 89.3%) of whom 817 (82.1%) had history of AF (43.6% paroxysmal, 21.7% persistent, 16.8% LSP. Among the 817 patients with AF, history of LSP AF was associated with reduced LAAev both in univariate (β=-8.65±1.70 cm/s, p<0.0001) and multivariate (β=-3.77±1.98 cm/s; p=0.05) analyses.

Conclusion: Even though CHA ₂ DS ₂ VASc score does not incorporate type of AF, we found LSP AF to be an independent marker for reduced LAAev. History of LSP AF should be considered in future AF-related stroke risk stratification models.