# Prevalentie van linkeratriumtrombus bij geanticoaguleerde AF-patiënten

*geplaatst 2021-06-15 · Atriumfibrilleren · Journal of the American College of Cardiology · doi 10.1016/j.jacc.2021.04.036 · https://hartvaat.nl/2021/06/15/prevalentie-van-linkeratriumtrombus-bij-geanticoaguleerde-af-patienten/*

Studie naar de prevalentie van linkeratriumtrombus bij AF-patiënten ondanks adequate anticoagulatie.

## English: Prevalence of Left Atrial Thrombus in Anticoagulated Patients With Atrial Fibrillation.

This study documented the prevalence of left atrial thrombus in AF patients despite guideline-directed anticoagulation, showing that a clinically relevant proportion harbors thrombus even on DOACs, informing pre-procedure screening decisions.

## Abstract (original, from the publication)

BACKGROUND: The prevalence of left atrial (LA) thrombus in patients with atrial fibrillation (AF) or atrial flutter (AFL) on guideline-directed anticoagulation is not well known, yet this may inform transesophageal echocardiogram (TEE) use before cardioversion or catheter ablation. OBJECTIVES: The purpose of this study was to quantify LA thrombus prevalence among patients with AF/AFL on guideline-directed anticoagulation and to identify high-risk subgroups. METHODS: EMBASE, MEDLINE, and CENTRAL were systematically searched from inception to July 2020 for studies reporting on LA thrombus prevalence among patients with AF/AFL undergoing TEE following at least 3 weeks of continuous therapeutic oral anticoagulation with vitamin K antagonists (VKAs) or direct oral anticoagulants (DOACs). Meta-analysis was performed using random effects models. RESULTS: Thirty-five studies describing 14,653 patients were identified. The mean-weighted LA thrombus prevalence was 2.73% (95% confidence interval [CI]: 1.95% to 3.80%). LA thrombus prevalence was similar for VKA- and DOAC-treated patients (2.80%; 95% CI: 1.86% to 4.21% vs. 3.12%; 95% CI: 1.92% to 5.03%; p = 0.674). Patients with nonparoxysmal AF/AFL had a 4-fold higher LA thrombus prevalence compared with paroxysmal patients (4.81%; 95% CI: 3.35% to 6.86% vs. 1.03%; 95% CI: 0.52% to 2.03%; p < 0.001). LA thrombus prevalence was higher among patients undergoing cardioversion versus ablation (5.55%; 95% CI: 3.15% to 9.58% vs. 1.65%; 95% CI: 1.07% to 2.53%; p < 0.001). Patients with CHA2DS2-VASc scores ≥3 had a higher LA thrombus prevalence compared with patients with scores ≤2 (6.31%; 95% CI: 3.72% to 10.49% vs. 1.06%; 95% CI: 0.45% to 2.49%; p < 0.001). CONCLUSIONS: LA thrombus prevalence is high in subgroups of anticoagulated patients with AF/AFL, who may benefit from routine pre-procedural TEE use before cardioversion or catheter ablation.

Auteurs: Antony Lurie, Jia Wang, Kyra J Hinnegan, William F McIntyre, Emilie P Belley-Côté, Guy Amit, Jeff S Healey, Stuart J Connolly, Jorge A Wong

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Bron: Journal of the American College of Cardiology, https://doi.org/10.1016/j.jacc.2021.04.036. Bijgewerkt 2026-07-03T13:28:23Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.