Anatomical Characteristics of the Left Atrial Appendage in Patients with Atrial Fibrillation with Stroke

Takehiro Kimura, Seiji Takatsuki, Nobuhiro Nishiyama, Kotaro Fukumoto, Yoshiyasu Aizawa, Yukiko Karube, Shunichiro Miyoshi, Keiichi Fukuda

Research output: Contribution to journalArticlepeer-review


Background: Strokes can develop in patients with atrial fibrillation (AF) having low CHADs2 score. We aimed to clarify the characteristics of left atrial appendages (LAAs) in non-valvular AF stroke patients with low CHADs2 score. Methods and Results: A total of 333 AF patients (paroxysmal : n=222) who underwent computed tomography (CT) and ablation were examined, out of whom 29 patients(8.7%) had strokes(22 males, 60±9yo, 22 paroxysmal). The average CHADs2 score at the onset of stroke was 0.6±0.6, the size of left atrium was 3.9±0.5cm and the blood flow velocity of LAA was 51 ±22cm/sec. LAA anatomy was classified into 4 types of morphologies: “Cauliflower”, “Windsock”, “Cactus”, and “Chickenwing”, and the distribution was compared with 51 age and sex matched control. Comparing stroke group vs. control group, Cauliflower was 69% vs. 31%, Windsock was 19% vs. 31%, Chickenwing was 4% vs. 22% and Cactus was 4% vs. 31%, respectively. Regarding the position of the LAA, lower position of LAA orifice than the left superior pulmonary veins were more common in stroke patients (stroke vs. control; 12 (80%) vs. 16 (31%), respectively. Conclusion: AF patients with low CHADs2 score and strokes had well-lobulated and lower positioned LAA. The anatomy of LAAs might be helpful to identify risks for strokes.

Original languageEnglish
Pages (from-to)435
Number of pages1
Journaljournal of arrhythmia
Issue number4
Publication statusPublished - 2011


  • AF
  • left atrial appendage
  • stroke

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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