Advertisement

Presence of accessory left atrial appendage/diverticula in a population with atrial fibrillation compared with those in sinus rhythm: a retrospective review

  • John Troupis
  • Marcus Crossett
  • Michal Scneider-Kolsky
  • Dee Nandurkar
Original Paper

Abstract

Accessory left atrial appendages and atrial diverticula have an incidence of 10–27%. Their association with atrial fibrillation needs to be confirmed. This study determined the prevalence, number, size, location and morphology of accessory left atrial appendages/atrial diverticula in patients with atrial fibrillation compared with those in sinus rhythm. A retrospective analysis of 47 consecutive patients with atrial fibrillation who underwent 320 multidetector Coronary CT angiography (CCTA) was performed. A random group of 47 CCTA patients with sinus rhythm formed the control group. The presence, number, size, location and morphology of accessory left atrial appendages and atrial diverticula in each group were analysed. Twenty one patients had a total of 25 accessory left atrial appendages and atrial diverticula in the atrial fibrillation group and 22 patients had a total of 24 accessory left atrial appendages and atrial diverticula in the sinus rhythm group. Twenty-one atrial diverticula were identified in 19 patients in the atrial fibrillation group and 19 atrial diverticula in 17 patients in the sinus rhythm group. The mean length and width of accessory left atrial appendage was 6.9 and 4.7 mm, respectively in the atrial fibrillation group and 12 and 4.6 mm, respectively, in the sinus rhythm group, P = ns (not significant). The mean length and width of atrial diverticulum was 4.7 and 3.6 mm, respectively in the atrial fibrillation group and 6.2 and 5 mm, respectively in the sinus rhythm group (P = ns). Eighty-four % and 96% of the accessory left atrial appendages/atrial diverticula in the atrial fibrillation and sinus rhythm groups were located along the right anterosuperior left atrial wall. Accessory left atrial appendages and atrial diverticula are common structures with similar prevalence in patients with atrial fibrillation and sinus rhythm.

Keywords

Atrial fibrillation Accessory left atrial appendage Atrial diverticulum Cardiac CT Sinus rhythm Thrombus 

Notes

Conflict of interest

Authors have no conflict of interest to declare.

References

  1. 1.
    Duerinckx AJ, Vanovermiere O (2007) Accessory appendages of the left atrium as seen during 64 slice CT angiography. Int J Cardiovas Imaging 24(2):215–221CrossRefGoogle Scholar
  2. 2.
    Wan Y, He Z, Zhang J et al (2009) The anatomical study of left atrium diverticulum by multidetcetor row CT. Surg Radiol Anat 31:191–198PubMedCrossRefGoogle Scholar
  3. 3.
    Abbara S, Mundo-sagardia JA, Hoffmann U, Cury RC (2009) Cardiac CT assessment of left atrial accessory appendages and diverticula. Am J Roengenol 193:807–812CrossRefGoogle Scholar
  4. 4.
    Igawa O, Miake J, Adachi M (2008) The small divericulum in the right anterior wall of the left atrium. Europace 10:120PubMedCrossRefGoogle Scholar
  5. 5.
    Srinivasan V, Levinsky L, Idbeis B, Gingell RL, Peironi DR, Subramanian S (1980) Congenital diverticulum of the left atrium. Cardiovasc Dis 7:405–410PubMedGoogle Scholar
  6. 6.
    Morrow AG, Behrendt DM (1968) Congenital aneurysm (diverticulum) of the right atrium: clinical manifestations and results of operative treatment. Circulation 38:124–128PubMedGoogle Scholar
  7. 7.
    Naqvi TZ, Zaky J (2004) Electric dissociation within left atrial appendage diagnosed by doppler echocardiography. J Am Soc Echocardiogr 17:1077–1079PubMedCrossRefGoogle Scholar
  8. 8.
    Killeen RP, O’Connor SA, Keane D, Dodd JD (2009) Ectopic focus in an accessory left atrial appendage, radiofrequency ablation of refractory atrial fibrillation. Circulation 120:60–62CrossRefGoogle Scholar
  9. 9.
    Pasricha SS, Nandurkar D, Seneviratne SK et al (2009) Image quality of coronary 320-MDCT in patients with atrial fibrillation: initial experience. AJR 193:1514–1521PubMedCrossRefGoogle Scholar
  10. 10.
    Killeen RP, Ryan R, MacErlane A, Martos R, Keane D, Dodd JD (2009) Accessory left atrial diverticulae: contractile properties depicted with 64 slice cine cardiac CT. Int J Cardiovas Imaging 26:241–248CrossRefGoogle Scholar
  11. 11.
    Poh AC, Juraszek AL, Ersoy H et al (2008) Endocardial irreregularities of the left atrial roof as seen on coronary CT angiography. Int J Cardiovas Imaging 24:729–734CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, B.V. 2011

Authors and Affiliations

  • John Troupis
    • 1
  • Marcus Crossett
    • 1
  • Michal Scneider-Kolsky
    • 2
  • Dee Nandurkar
    • 1
  1. 1.Department of Diagnostic ImagingMonash Medical CentreClaytonAustralia
  2. 2.Department of Medical Imaging and Radiation Sciences, School of Biomedical Sciences, Faculty of Medicine, Nursing and Health SciencesMonash UniversityClaytonAustralia

Personalised recommendations