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Published online: 2023-07-26

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Anatomy of the right atrial appendage and its importance in clinical practice

Jiani Zhang1, Mingyuan Yuan1


The right atrial appendage is an important anatomical marker of the right heart. With the developments in cardiology, more attention has been paid to the right atrial appendage. This article summarizes the progress in research regarding the right atrial appendage anatomy and its clinical value, to collate and augment the relevant data. The shape of the right atrial appendage differs from the left atrial appendage: its outer surface is relatively flat and its internal structure comprises a terminal crest and musculi pectinati. In clinical interventional therapy, the right atrial appendage is often used as the electrode implantation site. The thickness of the musculi pectinati and the wall thickness of the right atrial appendage are closely related to the outcomes in atrial lead implantation. In terms of atrial fibrillation, wherein thrombi formation is frequent, the right atrial appendage is one of the predilection sites of thrombosis. However, the incidence of thrombosis in the right atrial appendage is lower than that in the left atrial appendage. Familiarity with the anatomy of the right atrial appendage is of prime importance in atrial lead implantation, and the role of the right atrial appendage in atrial fibrillation requires further investigation.

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