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Object: Assessment of the morphology of the left atrial appendage volume and function of left atrial appendage in patients with atrial fibrillation by real-time three-dimensional transesophageal echocardiography Method: sixty-seven patients underwent transesophageal echocardiography, males 37,females 30,average age 53.87± 14.59.Divide patients into atrial fibrillation group and defibrillator group,and divide atrial fibrillation group into NO SEC group、 SEC group and TH group.Morphology was observed and lobes of LAA were counted and the left atrial appendage length(LAA-L)、 width of orifice (LAA-D)、 orifice area(LAA-O)、 long axis area(LAA-A) and volume (LAA-V) measured on the real time dimensional transesophageal echo-graphic images;the empty velocity of left atrial appendage(LAA-v) measured by Doppler;the volume of left atrial(LA-V) measured on transthoracic echocardiographic images.Results: Lobulation: in 67 patients with ideal images, 9 have one leaf, 29 have double leaves, 22 have three leaves and 7 have 4 leaves or more.The number of lobes of LAA in defibrillator group,NO SEC group,SEC group and TH group are2.58± 1.24、 2.50±0.98、 3.22± 1.30 及 3.46±0.97.TH group have the much more lobes than other groups(P <0.05).Diameter and volume: LAA-DI of TH group is larger than other three groups(P <0.01),LAA-OI and LAA-EDVI of TH group and SEC group are larger than NO SEC group and defibrillator group(P <0.01), but there is no differents of LAA-LI and LAA-AI between each group.LA-VI of fibrillator group is larger than defibrillator group(P <0.01).Function: LAA-EF and LAA-v of fibrillation group are lower than defibrillation group(P <0.01),and LAA-EF and LAA-v of TH group and SEC group are lower than NO SEC group(P <0.01).Relation analysis: LAA-DI is positively related to LAA-LI(r=0.66,P <0.01),LAA-DI is also positively related to LAA-OI(r=0.75,P <0.01),LAA-OI is positively related to LAA-EDVI(r=0.639,P <0.01),LAA-EDVI is positively related to LA-VI(r=0.317,P <0.05);LAA-EDVI is negatively related to LAA-v(r=-0.258,P <0.05),LAA-EDVI is negatively related to LAA-EF(r=-0.518,P <0.01).Conclusions: Most left atrial appendages are un-regular and have lobes.Double-lobes LAA is more common,then is the triple-lobes LAA.LAA with thrombus has more lobes and more specific morphology.The volume of LAA in fibrillater patient enlarged,the volume is even larger in SEC and TH group.LAA-D and LAA-O are more significantly larger than LAA-L and LAA-A.The function of left atrial appendage of patients with atrial fibrillation reduced, at the same time the volume enlarged, the volume of left atrial appendages with thrombus formed are even larger, the changes of the function and the volume have synchronism.Real-time three-dimensional transesophageal echocardiography presents the whole three-dimensional morphology and inside structure of left atrial appendage,which makes up the shortage of single plane images collected by two-dimensional transesophageal echocardiography.And Real-time three-dimensional transesophageal echocardiography provides more information for echo-graphic evaluation of left atrial appendage.