The Risk Factor Of Thrombus Formation and the Effect of Catheter Ablation on Repetitive Thrombus Formation in Patients With Atrial Fibrillation

Objectives: We aimed to explore the influencing factors of thrombus formation in patients with atrial fibrillation (AF) and provide primary evidence about the effect of catheter ablation (CA) on recurrent thrombosis in patients with a history of intracardiac thrombus.Methods: This study consisted of 1726 patients that underwent CA. The baseline data and recurrence of atrial tachyarrhythmia were recorded. We explored the risk factors for thrombus formation(thrombosis). We tested for the formation of intracardiac thrombus and left atrial appendage flow velocity (LAAFV) in patients with a history of intracardiac thrombus who were willing to undergo transesophageal echocardiography at the latest follow-up.Results: Intracardiac thrombus was detected in 58 of 1726 patients prior to CA (3.36%); persistent AF is the only independent risk factor affecting the formation of atrial thrombus (OR, 3.152; 95%CI, 1.806 to 5.500; p <0.001). 27 patients agreed to undergo transesophageal echocardiography during follow-up; no clinical ischemic stroke events was recorded, 15 maintained the sustained sinus rhythm (55.6%) during follow-up; recurrent intracardiac thrombus formation was detected in one patient; successful CA significantly increased LAAFV (difference between latest evaluation and prior to CA 17.46±14.81cm/s, P <0.001).Conclusions: According to this preliminary study, persistent AF is the only independent risk factor for thrombus formation. It may be reasonable that CA improved the substrate of thrombus formation. Additional multicenter prospective studies are required to identify further management measures to prevent recurrent thrombus formation.