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Background: The aim of this study was to examine the prevalence of abnormal P‐wave parameters in patients with thrombus and/or spontaneous echo contrast (SEC) in the left atrial appendage (LAA), and to identify P‐wave parameters particularly associated with thrombus and SEC formation. Hypothesis: We presume a significant relationship of P‐wave parameters with thrombi and SEC. Methods: All patients in whom a thrombus or SEC was detected in the LAA on transoesophageal echocardiography were included in this study. Patients at risk (CHA2DS2‐VASc Score ≥3) and routine transoesophageal echocardiography to exclude thrombi served as the control group. A detailed ECG analysis was performed. Results: Of a total of 4062 transoesophageal echocardiographies, thrombi and SEC were detected in 302 patients (7.4%). Of these patients, 27 (8.9%) presented with sinus rhythm. The control group included 79 patients. There was no difference in mean CHA2DS2‐VASc score in the two groups (p =.182). A high prevalence of abnormal P‐wave parameters was detected in patients with thrombus/SEC. Indicators for the presence of thrombi or SEC in the LAA were P‐wave duration >118 ms (Odds ratio (OR) 3.418, Confidence interval (CI) 1.522–7.674, p <.001), P‐wave dispersion >40 ms (OR 2.521, CI 1.390–4.571, p <.001) and advanced interatrial block (OR 1.431, CI 1.033–1.984, p =.005). Conclusion: Our study revealed that several P‐wave parameters are associated with thrombi and SEC in the LAA. The results may help identify patients who are at particularly high risk for thromboembolic events (e.g., in patients with embolic stroke of undetermined source). [ABSTRACT FROM AUTHOR]

Background: There are few large studies on which factors are associated with the occurrence of arrhythmias. Implantable loop recorders (ILR) are useful in detecting arrhythmia due to prolonged and continuous ECG monitoring. Therefore, the aim of this study is to identify and evaluate clinical characteristics and ECG parameters for predicting arrhythmias requiring pacemaker/ICD implantation by analyzing a study cohort with ILR. Methods: This bicentric study comprised a study cohort of 451 patients (mean age 64 ± 16 years, 209 women) receiving ILR implantation between 2011 and 2021. Patients were followed up on a 3 monthly outpatient interval. All arrhythmias with a pacemaker or ICD indication were considered clinically relevant. The primary study endpoint was the detection of clinically relevant arrhythmia. Results: During a follow up of 678 ± 392 days, a clinically relevant arrhythmia was detected in 81 of 451 patients (18%). Multivariate analysis revealed five independent risk factors: coronary artery disease (HR 1.954, CI 1.077–3.546, p =.028), atrial fibrillation (HR 2.253, CI 1.201–4.228, p =.011), previous syncope (HR 6.404, CI 3.202–12.808, p <.001), right bundle branch block (HR 4.370, CI 2.215–8.621, p <.001) and left bundle branch block (HR 2.685, CI 1.116–6.461, p =.028). Our risk model, based on these independent predictors, divided the study cohort into patients with low (2%), intermediate (18%), medium (34%), and high (45%) risk for clinically relevant arrhythmia. Conclusion: By the use of ILR, a clinically relevant arrhythmia has been detected in almost one fifth of the study cohort. In addition, clinical and electrocardiographic parameters were shown to be suitable predictors of clinically relevant arrhythmia. [ABSTRACT FROM AUTHOR]