The profile of patients with atrial fibrillation scheduled for cardioversion or catheter ablation hospitalized in a Romanian rehabilitation hospital

Abstract

Objectives - Structural cardiac, mainly atrial remodeling in non-valvular atrial fibrillation (NVAF) creates conditions for
thromboembolic complications, despite the optimization of oral anticoagulant treatment over the past years. This study aims to
provide a comparative analysis of patients with NVAF, with and without atrial thrombotic masses, in an integrated approach
using clinical, electrocardiographic, anatomohemodynamic cardiac findings assessed by echocardiography, as well as an
evaluation of the inflammatory status based on the usual screening blood markers. Methods – The study was based on the
anonymous analysis of the medical records of 50 patients with NVAF monitored in a center of cardiology in Cluj-Napoca
between March 2019 – February 2020, who received optimal oral anticoagulant treatment, all undergoing transesophageal
ultrasound prior to cardioversion or ablation therapy. The statistical data processing methods were based on the “chi square” test
and overall model fit logistic regression. Results – Atrial thrombotic complications were found in 7 (14%) patients with NVAF.
These had, compared to patients without thrombotic masses, a mean CHA2DS2-VASc scale of 3 versus 2.76 (p=0.05), more
frequently other atrial tachyarrhythmias (p<0.01), a more expressed inflammatory reaction (p=0.02), as well as a reduction of
LVEF (p<0.01) and the peak left atrial appendage emptying velocity (p<0.01). Conclusions – In addition to a high CHA2DS2-
VASc score, left anatomohemodynamic cardiac alteration, atrial arrhythmic complexity and background inflammatory status
create conditions for high thromboembolic risk in patients with NVAF.