P-wave parameters and their association with thrombi and spontaneous echo contrast in the left atrial appendage

  • \(\bf Background:\) The aim of this study was to examine the prevalence of abnormal P-wave parameters in patients with thrombus and/or spontaneous echo contrast (SEC) in the left atrial appendage (LAA), and to identify P-wave parameters particularly associated with thrombus and SEC formation. \(\bf Hypothesis:\) We presume a significant relationship of P-wave parameters with thrombi and SEC. \(\bf Methods:\) All patients in whom a thrombus or SEC was detected in the LAA on transoesophageal echocardiography were included in this study. Patients at risk (CHA2DS2-VASc Score \(\geq\)3) and routine transoesophageal echocardiography to exclude thrombi served as the control group. A detailed ECG analysis was performed. \(\bf Results:\) Of a total of 4062 transoesophageal echocardiographies, thrombi and SEC were detected in 302 patients (7.4%). Of these patients, 27 (8.9%) presented with sinus rhythm. The control group included 79 patients. There was no difference in mean CHA2DS2-VASc score in the two groups (\(\it p\) = .182). A high prevalence of abnormal P-wave parameters was detected in patients with thrombus/SEC. Indicators for the presence of thrombi or SEC in the LAA were P-wave duration >118 ms (Odds ratio (OR) 3.418, Confidence interval (CI) 1.522–7.674, \(\it p\) < .001), P-wave dispersion >40 ms (OR 2.521, CI 1.390–4.571, \(\it p\) < .001) and advanced interatrial block (OR 1.431, CI 1.033–1.984, \(\it p\) = .005). \(\bf Conclusion:\) Our study revealed that several P-wave parameters are associated with thrombi and SEC in the LAA. The results may help identify patients who are at particularly high risk for thromboembolic events (e.g., in patients with embolic stroke of undetermined source).

Download full text files

Export metadata

Additional Services

Share in Twitter Search Google Scholar
Author:Fabienne KreimerORCiDGND, Julian Felix BackhausGND, Christos KrogiasORCiDGND, Andreas PflaumbaumGND, Andreas MüggeORCiDGND, Michael GotzmannORCiDGND
Parent Title (English):Clinical cardiology
Place of publication:Weinheim
Document Type:Article
Date of Publication (online):2024/01/19
Date of first Publication:2023/02/17
Publishing Institution:Ruhr-Universität Bochum, Universitätsbibliothek
Tag:Open Access Fonds
P‐wave parameters; atrial cardiomyopathy; atrial fibrillation; ischemic stroke; spontaneous echo contrast; thrombus
First Page:397
Last Page:406
Article Processing Charge funded by the Deutsche Forschungsgemeinschaft (DFG) and the Open Access Publication Fund of Ruhr-Universität Bochum.
Institutes/Facilities:St. Josef-Hospital Bochum, Neurologische Klinik
St. Josef-Hospital Bochum, Klinik für Kardiologie, Abteilung für Rhythmologie
Dewey Decimal Classification:Technik, Medizin, angewandte Wissenschaften / Medizin, Gesundheit
open_access (DINI-Set):open_access
Licence (English):License LogoCreative Commons - CC BY 4.0 - Attribution 4.0 International