AMA Category 1 Credit for Physicians Only.
ASRT CME is not available.
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If the velocity of the LAA is low, one would expect that stasis and an environment for thrombus formation would be present. Where you measure LAA velocity is important. The velocity is higher 1 cm below the LAA orifice than 1 cm from the LAA apex. The normal LAA velocity exceeds 50 cm/sec.
In patients with atrial fibrillation, the LAA emptying velocity drops. One study found that elderly patients with low LVEF (< 40%) and a LAA velocity (LAAV) < 20 cm/sec were more likely to develop LAA thrombi. A TTE will measure about the same velocities as TEE so the modality is not important. One study showed that TTE measured LAAV at 50 cm/sec were measured at 47 cm/sec.
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low left atrial appendage velocity
and Factor V promoter sequence variation as predictors of left atrial thrombosis in patients with nonvalvular atrial fibrillation.
Transthoracic Doppler echocardiography for the assessment of left atrial appendage size and blood flow velocity: a multicentre study.