Age alone is not a risk factor for left atrial thrombus in atrial fibrillation

Benjamin Mazouz ¹, Andre Keren ¹ and Adrian Chenzbraun ^2*

¹ Bikur Cholim Hospital, Jerusalem, Israel
² Royal Liverpool University Hospital, United Kingdom

^* To whom correspondence should be addressed. E-mail: a.chenzbraun{at}btinternet.com.

Accepted 15 May 2007

Abstract

Objective Advanced age is an indication for anticoagulation in patients with atrial fibrillation though it is not clear that elderly patients have a higher prevalence of left atrial thrombus. The purpose of this study was to clarify whether advanced age represents a risk for left atrial thrombus formation irrespective of other clinical variables

Design Observational study in patients with atrial fibrillation undergoing a transoesophageal echo scan for various clinical indications.

Setting University affiliated cardiology service in a general hospital.

Patients Results are reported in 381 patients, 257 aged less than 75 years (Gr. A) and 124 aged 75 years or more (Gr. B).

Results Thrombi were detected by TOE in 30 patients (7.9%), 21 from group A and 9 from group B (8.1% vs. 7.2%, p=ns). No thrombi were detected in patients with lone atrial fibrillation. Among patients with either valvular or nonvalvular atrial fibrillation, left atrial thrombus presence was not related to age or anticoagulation status

Conclusions In patients with atrial fibrillation, age itself does not predict the presence of left atrial thrombus and the only identifiable risk factor seems to be the existing cardiac pathology.

Keywords: anticoagulation, atrial fibrillation, elderly, transesophageal echocardiography

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