Quotesafib What I meant was that imaging can play a role in screening not for whether afib originates in the LAA, but rather for the stroke risk associated with the morphology (structure) of the LAA in the presence of afib. This type of imaging and risk stratification is not usually carried out in the paroxysmal population from what I can tell. Despite having undergone an MRI with contrast, a Cby Carey - AFIBBERS FORUM
Shannon, Thank you for your informative and thoughtful reply during a difficult time. I am of course a layman in understanding medical procedures etc. I never meant to pass on as fact my incomplete understanding of the circumstances under which someone can stop AC. What I was trying to say, and did it poorly, is if my LAA was a source of afib or flutter and was also electrically isolated, dby AB Page - AFIBBERS FORUM
So a couple days ago I somehow had full access to the just released AHA journal article authored by Natale, Dibiase and Romero detailing and supporting the effect of electrically isolating the LAA. The full article is now behind a paywall, but there was a discussion that really caught my eye, and I'm hoping someone else may have read it and be able to explain it a little better for me. The aby AB Page - AFIBBERS FORUM
LAA morphology has been discussed here previously, here is a search and most of the hits are relevant < QuoteJoe BTW, an interesting Sauna study at the end of your link, Liz Thanks for posting! The sauna study is interesting, it rotated off the link, so here is what Joe was referring to: < Dr. Rhonda Patrick has looked at this a lot. She interviews Dr. Jari Laukkanen, who has studby GeorgeN - AFIBBERS FORUM
Natale just read my CAT scan from 2 years ago when I had my LAA isolated. Guess what ...I have a chicken wing morphology but I suffered a TIA 7 years ago before my first ablation. Thankfully it was a 5min episode where I couldn't speak, a micro-infraction that had no lasting damage. Maybe if I had one of the other three i'd be paralyzed or dead but nontheless I suffered a stroke!by McHale - AFIBBERS FORUM
How many have a "chicken wing" LAA? The shape of the left atrial appendage may have something to do with the risk of ischemic stroke in patients with atrial fibrillation, researchers found. Of the four shapes characterized by researchers, the one called Chicken Wing carried a 79% decreased risk of stroke or transient ischemic attack (TIA), according to Andrea Natale, MD, from theby Elizabeth - AFIBBERS FORUM
(This post is an addition to my original post.) Here is a study by Dr. Luigi Di Biase entitled "Can the shape of the left atrial appendage affect stroke risk?" https://www.einstein.yu.edu/departments/medicine/divisions/cardiology/news/shape-of-heart-and-stroke-risk.aspx In patients with atrial fibrillation, stroke risk is managed with oral anticoagulants (blood thinners such asby gmperf - AFIBBERS FORUM
Hi Barb - The Sept. 25, 2015 issue of JAFIB has a report complete with photos on the morphology of the LAA. Left Atrial Appendage Morphology and Silent Cerebral Ischemia in Patients with Atrial Fibrillation Credits: Ajay Vallakati , Metrohealth Medical Center, Case Western Reserve University, Ohio Turin, Italy: Patients with AF have 5 times increased risk of symptomatic stroke comparedby Jackie - AFIBBERS FORUM
HI Researcher, In answer to the first post above here is my reply which I first added by mistake to your own post and have since moved it here after realizing I clicked in the wrong box :-). They use Carto 3D and ICE .. CT, MRI or 3D-TEE is used for LAA morphological classification when needed, such as before any ligation or exclusion device or procedure. .. or also just to type the morphoby Shannon - AFIBBERS FORUM
Last question first, the stroke risk for former AFIBBers who have had a successful ablation process that restored full time unbroken NSR, has been shown in a number of studies (most recently in large study at Intermountain Utah) to fall to that of those of the same age/sex matched population control group who have never had AFIB. Next question, LAA morphology applies, of course, as this just cby Shannon - AFIBBERS FORUM
I was intrigued by the article "Left Atrium Appendage (LAA) Morphology and Physiology 'The Missing Piece of the Puzzle'" in the most recent Afib Report, June/July 2015. I am wondering if this additional diagnostic, LAA morphology classification, would apply to CHA2DS2 patients who have been successfully ablated, such as myself. I have a CHA2DS2 score of 0 and was recentlyby Que - AFIBBERS FORUM
Hi Barb, Your heart of fine so no worries. The fibrosis is not that uncommon in people our age, especially women. Your LVEF Left ventricular ejection fraction is still in the normal range and is good so don't fret over this, its just that it adds more of an emphasis on getting your TEE and, if need be after the results, continuing on with the anti-coagulation program. Its not a real woby Shannon - AFIBBERS FORUM
Liz, That serious adverse event rate of 9% was derived from a quite small group of patients at obviously a not very experienced center and marginal EPs as well on average to get that bad of results... In the much larger study of 80,000 ablation patients across the US over ten years they noted a major difference between complication rates with more experienced EPs and centers compared to the 8by Shannon - AFIBBERS FORUM
Hi Louise, Thanks for the reminder about the more recent small study on Nattokinase. I fully believe the results and it follows clearly what has been known for some time about its benefits. Keep in mind that I AM a big believer in using it appropriately. I also am sure that is will help reduce the risk of clot formation in most cases where there isn't a more significant driver or suby Shannon - AFIBBERS FORUM
I am new to this group and have been fascinated by the amount of great information on this site. I was diagnosed with asymptomatic, lone, paroxysmal afib a little over 2 years ago. I was prescribed diltiazem and 81 mg aspirin. I recently had a 7 day holter and it showed I am in afib about 30% of the time (never felt anything while in afib). After this holter, my ep suggested that I go on antby Allan - AFIBBERS FORUM
Hi Hans, I did read through the much larger study by Natale's group with Luigi Di Biase as the lead investigator listed in the authors listing on the LAA Morphology and stroke issue in low CHADS2 score afibbers. There was something like 932 patients evaluated by CT or MRI for LAA shape and size versus only 90-patients in the Japanese study. In the Natale group study they used a bitby Shannon - AFIBBERS FORUM
Hi Hans At the moment I only have the full Japanese study on hand called 'Anatomical Characteristics of the Left Atrial Appendage in Cardiogenic Stroke with low CHADS2 scores' Also there is not a clear demarcation between Lone Afibbers and those will one or more of the co-morbitities that certainly complicate the stroke risk picture for sure. And I agree it is not age, per se, buby Shannon - AFIBBERS FORUM
Hi George,McHale, Betty, I will try to answer the three questions/comments in order... George, that's a good question.. Dr N said he noticed some delay already in my LAA, no doubt from the TEE I had just before that first ablation in 08 in Austin, and that there was some further progress in that slowing velocity noted during the LAA Isolation ablation last Aug 2012. As such, we both kby Shannon - AFIBBERS FORUM
Most definitely for the vast majority of Afibbers in the Lone paroxysmal category the stroke risk is very low.. no doubt a good deal lower than Big Pharma would have us believe. Also, I'm convinced that when it really is early to middle stage ( meaning roughly within the first 5 to 8 years of AFI the vast majority without other co-factors like CVD, Hypertension, Obstructive Sleep Apnea, pby Shannon - AFIBBERS FORUM
Stroke risk related to AFIB is almost entirely related to thrombus clot formation in the LAA that then gets embolized and travels .. either to the brain most commonly or as a Pulmonary embolism. Such a clot in the LAA can become embolic after conversion from AFIB/Flutter to NSR or a jolt from an ECV or even a hard fall or thump on the chest and even from spontaneous dislodgement over time.by Shannon - AFIBBERS FORUM
Buster Wrote: ------------------------------------------------------- > From another thread > Stroke and Chicken Wing Shape > of LAA > > Does anyone know if Dr. Natale or other EPs who > perform ablations use the shape of the left atrial > appendage (LAA) in their determination whether or > not to recommend that their patients take > blood-thinners for the rby Shannon - AFIBBERS FORUM
Buster Wrote: ------------------------------------------------------- > From another thread > Stroke and Chicken Wing Shape > of LAA > > Does anyone know if Dr. Natale or other EPs who > perform ablations use the shape of the left atrial > appendage (LAA) in their determination whether or > not to recommend that their patients take > blood-thinners for the rby McHale - AFIBBERS FORUM
From another thread Stroke and Chicken Wing Shape of LAA Does anyone know if Dr. Natale or other EPs who perform ablations use the shape of the left atrial appendage (LAA) in their determination whether or not to recommend that their patients take blood-thinners for the rest of their lives when the isolation of the LAA significantly impairs its function?by Buster - AFIBBERS FORUM
Thanks for that McHale, Very interesting article. I had read previously that the shape and size of the LAA can influence stroke risk and that the more persistent and long duration one's AFIB is, the greater the likelihood the LAA can grow in size and develop more lobes etc, but this is the first study with such definitive LAA shape categories correlated with increased of decreased strokeby Shannon - AFIBBERS FORUM
I always wondered about the shape of the LAA and strokeby McHale - AFIBBERS FORUM