Risk Factors For Left Atrial Thrombus Or Spontaneous Echo Contrast In Patients With Non Valvular Atrial Fibrillation Before Radiofrequency Ablation

Objective:To explore the risk factors of left atrial thrombus(LAT)and spontaneous echo contrast(SEC)before radiofrequency ablation of non-valvular atrial fibrillation.Methods:In January 2013 to December 2014,during the hospitalization fitting line of radiofrequency ablation Nonvalvular atrial fibrillation(NVAF)of 466 cases patients with preoperative through Transesophageal echocardiography(TEE),according to the result of the Transesophageal echocardiography is divided into two groups:LAT/SEC to form groups and no LAT/SEC.Compared two groups of patients' age,sex,clinical types,atrial fibrillation history of related(including hypertension,coronary atherosclerotic heart disease,type 2 diabetes,ischemic stroke and Transient ischemic attack(TIA)),alcohol and tobacco addiction,laboratory examination indexes(including blood lipid level and Fibrinogen(Fibrinogen,FIB),C-reactive protein(C-reactive protein,CRP),D-dimer,thyroid function,blood routine)and relevant imaging examination results,And using Logistic multi factor regression analysis of the independent risk factors of LAT/SEC.Results:Group compared with no LAT/SEC,LAT/SEC group of patients,the proportions of the age,drinking,persistent af,chest radiograph cardiothoracic ratio,thoracic aortic wall sclerosis,Left atrium diameter(LAD),Left ventricular ejection fraction(LVEF),CHA2DS2 VASc score increased,C-reactive protein,platelet count were significantly higher than the group without LAT/SEC.Logistic regression analysis showed that:thoracic aortic wall sclerosis(OR=3.164,95%CI 1.52-5.406),persistent atrial fibrillation(OR=5.468,95%CI 3.316-9.019),left atrial diameter>40mm(OR=2.284,95%CI 1.184-4.405),C-reaction protein increased(OR=2.598,95%CI 1.167-5.780),CHA2DS2-VASc score?2(OR=1.663,95%CI 1.024-2.701)independent risk factors for the formation of LAT/SEC(P<0.05).Conclusion:In addition to the CHA2DS2-VASc scoring system,thoracic aortic wall sclerosis,persistent atrial fibrillation,left atrial diameter>40 mm,and elevated C-reactive protein were also independent predictors of LAT/SEC formation and contributed to the prediction of atrial fibrillation LAT or SEC risk.