ATRIAL FIBRILLATION is the most prevalent permanent arrhythmia. It may be associated with other cardiac pathologies which need surgical treatment. Various types of surgery including the traditional cut-sew operations and operations using different energy sources are currently in use. In comparison with medical treatment, surgery is safe, effective, and has reliable results.

Background: ATRIAL Flutter (AFL) and ATRIAL FIBRILLATION (AF) are among the most common supraventricular tachyarrhythmias. Sometimes, differentiation of the two arrhythmias using surface electrocardiography becomes difficult. Objectives: This study aimed to compare the Left ATRIAL Appendage (LAA) ejection flow waves of AFL and AF to determine whether it can serve as a method for differentiating the two arrhythmias. Methods: This cross-sectional study was conducted on 20 patients with AF and 20 ones with AFL selected via simple sampling method. During Trans-Esophageal Echocardiography (TEE), pulsed Doppler sampling was laid 1 cm inside the LAA and pattern of LAA ejection flow waves was recorded in terms of rate (number per minute), velocity (centimeter per second), and regularity. The two groups were compared using Mann-Whitney U-test. P ≤ 0. 05 was considered to be statistically significant. Results: The rate of LAA ejection flow waves was 493. 75 ± 50. 57 in the AF group and 303. 50 ± 16. 31 in the AFL group (P < 0. 001). Besides, the mean velocity was 0. 172 ± 0. 069 m/s in the AF group and 0. 302 ± 0. 106 m/s in the AFL group (P < 0. 001). Velocity more than 0. 17 m/s had a sensitivity of 95. 0% (95% CI, 75. 1-99. 2%), specificity of 70. 0% (95% CI, 45. 7-88. 0%), positive predictive value of 76. 0%, and negative predictive value of 93. 03% for diagnosing AFL. All patients in the AF group had irregular patterns, but all those in the AFL group had regular patterns. Conclusion: Since TEE is a usual part for evaluation of patients suspected to have AF or AFL, it may be helpful for differentiating AFL from AF by examining LAA ejection flow waves.

Objective(s): Appendage is the growth of the left atrium, which is different in terms of shape and size. This research aimed to investigate the relationship between the shape of the left atrium appendage and ATRIAL FIBRILLATION incidence. Methods: In a cross-sectional study, using the census method, 25 patients diagnosed with ATRIAL FIBRILLATION and a candidate for cardioversion were examined for the shape of the left ATRIAL FIBRILLATION in Farshchian Heart Hospital in Hamedan from 2021 to 2022. Threedimensional echocardiography with an esophageal probe was used to detect LAA morphology. Data, after recording in the checklist, were analyzed with SPSS software (version 26). Results: Patients had a mean age of 56. 64±12. 31 years. Males accounted for 32% of the patients and females for 68%. The frequency of chicken-wing, cactus, cauliflower, and windsock in the left atrium was 52%, 40%, 4%, and 4%, respectively. The mean and standard deviation of blood flow velocity in chicken-wing, cactus, cauliflower, and windsock forms were 14. 92±3. 90, 40. 70±9. 62, 23. 00, and 32. 00 cm/s, respectively (P˂0. 001). Shape of the left ATRIAL appendage had no significant difference with the type of ATRIAL FIBRILLATION regarding age, gender, diabetes, and blood pressure (P<0. 05 for all). Conclusion: In patients with ATRIAL FIBRILLATION, the frequency of left ATRIAL appendage morphology is different. Chicken-wing and cactus forms were the most common forms of left ATRIAL appendage in patients diagnosed with ATRIAL FIBRILLATION. The shape of the left atrium was significantly related to the flow rate, which seems to help predict thrombosis and ATRIAL FIBRILLATION.