What Your EP never told you: AF and TAA (Thoracic Aortic Aneurysm)

Posted by thisnthat @thisnthat, May 4 5:26pm

I’m going to bet your EP never warned you about a hidden risk you have as an AF patient: an elevated risk for developing a dilatation of your thoracic aorta. And as a result, a higher incidence of it also occurring in the aortic arch. The danger lies in the possibility of the aorta enlarging to the point where it my rupture or dissect, with catastrophic results.
Although I had a successful catheter ablation in 2020, a recent lung CT revealed the growth of my ascending thoracic aorta from 3.5 cm (2020/2021) to 3.8 cm (2022/2023), and now 4.1 cm. It seems there is a common pathway for the development of atrial fibrillation and a tendency to develop an enlargement of the thoracic aorta. Although my AF is in check, apparently the underlying issues continue unabated.
Right now the dilatation is considered ectatic, and not yet aneurysmal, but once it hits 4.5 cm, it is a TAA. There are specific guidelines as to when to intervene, depending on various factors, such as underlying connective tissue disorders, family history, other health issues, and rate of growth. (I believe growth more than .5 cm/year or .3 cm/more in consecutive years are red flags.)
I am not a medical professional. I just found this out on my own, researching the possible links between AF and TAAs.
Worth a talk with your cardiologist.

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@harveywj

Here is a recent article 2023 that basically is inclusive that Afib leads to TAA directly or they happen to occur as dual pathologies independent of each other. At least that is how I understand it. "Thoracic aortic aneurysm and atrial fibrillation: clinical associations with the risk of stroke from a global federated health network analysis"
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10017617/#:~:text=The%20findings%20regarding%20AF%20and,as%20hypertension%20and%20heart%20failure.
Conclusion
Our retrospective analysis from a large global federated dataset reports a clinical concomitance of AF and TAA. Importantly, in a PSM analysis, an increased risk of ischemic events in patients affected by both TAA and AF was evident, compared to AF alone. Whether this association simply reflects shared risk factors or commonality in pathophysiological pathways, it raises relevant clinical implications that deserve further investigation.

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Note I meant to write that the article I posted is "inconclusive" that Afib leads to TAA.

REPLY

Hi harveywj,
Sorry for the late reply! You are correct. Correlation is not necessarily causation, but still, a worrisome association, Also found this: https://www.ehealthme.com/cs/atrial-fibrillation-flutter/aortic-aneurysm/

True, older people do tend to have more heart disease and comorbidities, but it does makes you wonder: How might underlying pathologies contribute to one another? So, food for thought then (chicken vs. egg, perhaps! 🙃— or not!)….

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