Article Text

Download PDFPDF
Left atrial appendage anatomy and function: short term response to sustained atrial fibrillation
  1. M J Weigner,
  2. S E Katz,
  3. P S Douglas,
  4. W J Manning
  1. Department of Medicine (Cardiovascular Division) and the Harvard-Thorndike Laboratory of Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, USA
  1. Dr Manning. email: wmanning{at}


OBJECTIVE To determine whether there is significant atrial or atrial appendage enlargement or functional remodelling as a result of one to two months of sustained atrial fibrillation, a duration similar to that experienced by patients undergoing warfarin anticoagulation before elective cardioversion.

METHODS To test the hypothesis that left atrial and left atrial appendage enlargement develop as a result of short term atrial fibrillation, serial anatomical and functional indices were measured using transoesophageal echocardiography (TOE) in 20 patients with recent onset atrial fibrillation (14 men, six women; mean (SEM) age 67 (2) years). Serial TOE was performed 2.5 months apart in patients with sustained atrial fibrillation.

RESULTS There was no significant change in left atrial area (23.7 cm2 to 24.1 cm2, p = 0.98); length (5.7 cm to 5.7 cm, p = 0.48); width (5.2 cm to 5.2 cm, p = 0.65); volume (83 cm3 to 87 cm3, p = 0.51) or left atrial appendage area (7.9 cm2 to 8.1 cm2, p = 0.89); length (4.6 cm to 4.5 cm, p = 0.8); or width (2.5 to 2.4 cm, p = 0.87). Peak left atrial appendage velocity ejection (0.2 m/s to 0.2 m/s, p = 0.57), and presence of severe spontaneous echo contrast in the left atrial appendage (n = 15 (75%) to n = 13 (72%)) were also not significantly different. There was no correlation between changes in left atrial or left atrial appendage dimensions.

CONCLUSIONS In the setting of sustained atrial fibrillation, significant left atrial and left atrial appendage functional and anatomical remodelling do not occur with atrial fibrillation of a duration similar to that used for conservative anticoagulation in preparation for cardioversion.

  • atrial fibrillation
  • left atrial appendage
  • remodelling

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.