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https://www.readbyqxmd.com/read/29158017/left-atrial-appendage-occlusion-exclusion-procedural-image-guidance-with-transesophageal-echocardiography
#1
REVIEW
Alan F Vainrib, Serge C Harb, Wael Jaber, Ricardo J Benenstein, Anthony Aizer, Larry A Chinitz, Muhamed Saric
Atrial fibrillation is the most common arrhythmia worldwide and is a major risk factor for embolic stroke. In this article, the authors describe the crucial role of two- and three-dimensional transesophageal echocardiography in the pre- and postprocedural assessment and intraprocedural guidance of percutaneous left atrial appendage (LAA) occlusion procedures. Although recent advances have been made in the field of systemic anticoagulation with the novel oral anticoagulants, these medications come with a significant risk for bleeding and are contraindicated in many patients...
November 17, 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/29153925/lateral-atlantoaxial-joint-meniscoid-volume-in-individuals-with-whiplash-associated-disorder-a-case-control-study
#2
Scott F Farrell, Subaat Khan, Peter G Osmotherly, Michele Sterling, Jon Cornwall, Darren A Rivett
BACKGROUND: Lateral atlantoaxial (LAA) joints are established sources of nociceptive input in chronic whiplash associated disorder (WAD). These joints contain intra-articular meniscoids that may be damaged in whiplash trauma. LAA joint meniscoid morphology has not been investigated comprehensively in a chronic WAD population, and it is unclear whether morphological differences exist compared to a pain-free population. OBJECTIVES: This study examined LAA joint meniscoid volume in individuals with chronic WAD who report pain in a distribution consistent with LAA joint pain...
November 10, 2017: Musculoskeletal Science & Practice
https://www.readbyqxmd.com/read/29151509/in-paroxysmal-atrial-fibrillation-patients-the-neutrophil-to-lymphocyte-ratio-is-related-to-thrombogenesis-and-more-closely-associated-with-left-atrial-appendage-contraction-than-with-the-left-atrial-body-function
#3
Yukihiro Fukuda, Mitsunori Okamoto, Shunsuke Tomomori, Hiroya Matsumura, Takehito Tokuyama, Yukiko Nakano, Yasuki Kihara
Objective The neutrophil-to-lymphocyte ratio (NLR) is an inflammation marker that can be used to detect atrial inflammatory changes, which may contribute to a reduced left atrial (LA) function and thrombosis. Our study aimed to determine whether or not the association of NLR with the LA appendage (LAA) function in relation to thrombogenesis differs from the association with the LA body function in paroxysmal atrial fibrillation (PAF) patients. Methods A total of 183 PAF patients were studied. The LA volume index, mitral flow velocity (A), and mitral annular motion velocity (A') were examined using transthoracic echocardiography...
November 20, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29150698/surgical-techniques-for-left-atrial-appendage-exclusion
#4
REVIEW
Sacha P Salzberg, Maximilian Y Emmert, Etem Caliskan
The increasing prevalence of atrial fibrillation with the aging population and its associated major morbidity and mortality due to thromboembolic stroke have resulted in intensive research on stroke prevention or stroke risk reduction strategies. Several surgical techniques for left atrial appendage (LAA) occlusion have evolved over the past decades. Surgeons have been using different techniques leading to highly variable and, in particular, poor data on outcomes. LAA closure is performed either as a concomitant procedure during open-heart surgery or as a stand-alone surgical procedure as part of minimally invasive (mini-thoracotomy or thoracoscopy) arrhythmia surgery...
November 17, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29149516/feasibility-of-percutaneous-left-atrial-appendage-closure-using-a-novel-lambre-occluder-in-patients-with-atrial-fibrillation-initial-results-from-a-prospective-cohort-registry-study
#5
Shaojie Chen, Boris Schmidt, Stefano Bordignon, Fabrizio Bologna, Takahiko Nagase, Nikolaos Tsianakas, Laura Perrotta, K R Julian Chun
BACKGROUND: The LAmbreۛ occluder is a novel device for percutaneous left atrial appendage closure (LAAC). The presented study aimed to report the initial experience in implantation of the novel LAmbre for LAAC in patients with non-valvular AF. METHODS: We conducted a prospective, observational, cohort registry study to evaluate the feasibility of percutaneous LAAC using the LAmbre occlude. RESULTS: Thirty patients (15 female, mean age 77...
November 17, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29143099/-left-atrial-appendage-clusure-in-nonvalvular-atrial-fibrillation-clinical-evidence-2017
#6
REVIEW
Steffen Gloekler, Bajram Hajredini, Simon Rycerz, Sebastian Jäckle, Werner Jung
Nonvalvular atrial fibrillation (AF) is the most common arrhythmia with a prevalence of 1-2% and affects approximately 15-20% of all octogenarians. Patients are at increased risk of thromboembolic stroke, with an overall risk of 5% per year. Thrombi form almost exclusively in the left atrial appendage (LAA), a blind sac-like heterogeneous structure trabeculated by pectinate muscles. In the past five decades, life-long oral anticoagulation (OAC) with vitamin K antagonists (VKA) has been the state-of-the art treatment to prevent stroke and systemic embolism from thrombi in AF...
November 15, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29130638/thromboembolism-after-watchman-tm-in-a-clopidogrel-non-responder-a-case-for-concern
#7
Ganesh Venkataraman, Kevin P Bliden, Udaya S Tantry, Paul A Gurbel
Atrial fibrillation (AF) is associated with an increased risk of stroke and thromboembolism (TE). The WATCHMAN(TM) left atrial appendage (LAA) closure device is indicated to reduce the risk of TE from the LAA in patients with non-valvular AF. Here, we present a case of a patient with device-related thrombus who suffered a TE event two months after WATCHMAN(TM) LAA closure and two weeks after switching from aspirin plus warfarin to aspirin plus clopidogrel therapy. Laboratory investigation identified the patient to be hypercoagulable and to be a non-responder to clopidogrel therapy...
November 11, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29129259/comparison-of-prevalence-and-management-of-left-atrial-appendage-thrombi-under-old-and-new-anticoagulants-prior-to-left-atrial-catheter-ablation
#8
Antoine Da Costa, Clarisse Delolme, Jean Baptiste Guichard, Antoine Gerbay, Romain Pierrard, Cécile Romeyer-Bouchard, Karl Isaaz
BACKGROUND: The prevalence and management of left atrial appendage (LAA) thrombi associated with new anticoagulants remain to be elucidated, especially prior to atrial fibrillation (AFib) ablation. This study sought to (1) compare the prevalence of LAA thrombi and/or severe LAA contrast under vitamin K antagonist (VKA) agents and novel oral anticoagulants (NOACs), (2) evaluate the rate of LAA thrombus resolution after anticoagulation modification, and (3) determine the predictive factors of LAA thrombi and severe LAA contrast in patients prior to LA AFib ablation...
November 2017: American Heart Journal
https://www.readbyqxmd.com/read/29126892/atrial-fibrillation-ablation-beyond-pulmonary-veins-the-role-of-left-atrial-appendage
#9
REVIEW
Jorge Romero, Andrea Natale, Luigi Di Biase
The role of pulmonary vein isolation in patients with non-paroxysmal atrial fibrillation (AF) is only modest. Several studies have demonstrated the role of the left atrial appendage (LAA) in initiating and maintaining of this arrhythmia. We review in this article the incremental benefit in free-arrhythmia recurrence of LAA electrical isolation in patients undergoing procedures for persistent AF or long standing persistent AF either using radiofrequency ablation, cryoablation or Lariat device implantation. Likewise, acute complications, anticoagulation and the risk of ischemic stroke after LAA electrical isolation (LAAEI) are analyzed...
November 7, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29125072/predictors-of-dependence-after-mca-ischemic-stroke-submitted-to-thrombolysis
#10
Renata Dal-Prá Ducci, Marcos Christiano Lange, Francisco Manoel Branco Germiniani, Viviane de Hiroki Flumignan Zétola
OBJECTIVES: Stroke is one of the most common causes of disability-adjusted life years worldwide. The aim of this study is to identify variables associated with dependence at 3 months and also after the first 3 months after the first-ever ischemic stroke (IS) in middle cerebral artery (MCA) territory submitted to intravenous thrombolysis (IVT). METHODS: A single-center cohort study of patients with first-ever MCA IS treated with IVT at the Hospital de Clínicas, Universidade Federal do Paraná, was followed over 5 years...
November 10, 2017: Neurological Research
https://www.readbyqxmd.com/read/29122931/outcome-of-left-atrial-appendage-occlusion-in-high-risk-patients
#11
Ahmed Masoud, Stefano Bartoletti, Timothy Fairbairn, Ayush Khurana, Periaswamy Velavan, William Lindsay Morrison, Afshin Khalatbari, Suneil Aggarwal, Nikhill Sharma, Paulus Kirchhof, Dhiraj Gupta
OBJECTIVE: Percutaneous left atrial appendage (LAA) occlusion can be an interventional alternative to oral anticoagulation for stroke prevention in patients with atrial fibrillation. METHODS: We delivered LAA occlusion therapy using a standardised approach to patient referral, multidisciplinary team assessment, implant criteria, imaging and follow-up. We analysed patient characteristics, efficacy and safety of the implant procedure, and 12-month outcomes. RESULTS: Of 143 referrals from October 2014 to December 2016, 83 patients (age 76±8 years, 32...
November 9, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29122133/percutaneous-left-atrial-appendage-closure-with-the-lambre-device-for-stroke%C3%A2-prevention-in-atrial-fibrillation-a-prospective-multicenter-clinical-study
#12
He Huang, Yu Liu, Yawei Xu, Zulu Wang, Yigang Li, Kejiang Cao, Shu Zhang, Yanzong Yang, Xinchun Yang, Dejia Huang, Bo Yu, Xi Su, Liqun Wu, Congxin Huang
OBJECTIVES: The authors sought to assess the clinical outcomes of left atrial appendage (LAA) closure with the LAmbre closure system in patients with nonvalvular atrial fibrillation (NVAF). BACKGROUND: Over 90% of thrombi are located in the LAA in NVAF patients. METHODS: A prospective, multicenter study was conducted in 153 NVAF patients with CHADS2 score ≥1. RESULTS: The LAA was successfully occluded in 152 patients...
November 13, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29121724/noacs-and-atrial-fibrillation-incidence-and-predictors-of-left-atrial-thrombus-in-the-real-world
#13
Emanuele Bertaglia, Matteo Anselmino, Alessandro Zorzi, Vincenzo Russo, Elisabetta Toso, Francesco Peruzza, Antonio Rapacciuolo, Federico Migliore, Fiorenzo Gaita, Umberto Cucchini, Marcello De Divitiis, Sabino Iliceto, Giuseppe Stabile
AIMS: Despite optimal oral anticoagulation with vitamin K antagonist, left atrial (LA) thrombus could be detected in the left appendage (LAA) in >2% of patients with atrial fibrillation (AF) and CHA2DS2-VASc score≥1 but few data are available for patients treated with non-vitamin K antagonist oral anticoagulants (NOACs). We evaluated the occurrence and predictors of LA thrombi by means of transesophageal echocardiography (TOE) in consecutive patients with non-valvular AF who received for at least 3weeks Apixaban, Dabigatran, or Rivaroxaban...
December 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29118917/influence-of-renal-function-on-the-association-between-homocysteine-level-and-risk-of-ischemic-stroke
#14
Yao Cheng, Fan-Zhen Kong, Xiao-Feng Dong, Qin-Rong Xu, Qian Gui, Wei Wang, Hong-Xuan Feng, Wei-Feng Luo, Zong-En Gao, Guan-Hui Wu
We examined whether the association between total homocysteine (tHCY) and risk of ischemic stroke (IS) varies depending on renal function to gain insight into why tHCY-lowering vitamins do not reduce the incidence of cardiovascular disease in clinical trials. We analyzed data from 542 IS patients with large artery atherosclerosis (LAA) or small artery occlusion (SAO) after stratification by estimated glomerular filtration rate (eGFR) to evaluate renal function. We found that tHCY level was positively associated with the occurrence of IS in both LAA (OR: 1...
2017: American Journal of Translational Research
https://www.readbyqxmd.com/read/29107175/entrapment-of-focal-atrial-tachycardia-using-cryoballoon-ablation-sinus-rhythm-in-the-left-atrium-and-ongoing-atrial-tachycardia-in-the-left-atrial-appendage
#15
Hikmet Yorgun, Uğur Canpolat, Banu Evranos, Kudret Aytemir
Left atrial appendage (LAA) is a well-known source of focal atrial tachycardias (AT). Although radio-frequency (RF) energy is the most commonly used technique in such cases, there was an option other than epicardial approach when RF technique fails. Cryoballoon technology is primarily developed to be used for pulmonary vein isolation (PVI). Also, there was no report regarding the isolation of LAA by using cryo-balloon in patients with focal AT. In this case, for the first time in the literature, we successfully isolated the LAA because of failed attempts of RF ablation for focal AT in whom the surface electrogram showed a sinus rhythm while arrhythmia continues inside the LAA...
October 28, 2017: Indian Pacing and Electrophysiology Journal
https://www.readbyqxmd.com/read/29103847/5-year-outcomes-after-left%C3%A2-atrial%C3%A2-appendage-closure-from-the-prevail-and-protect-af-trials
#16
Vivek Y Reddy, Shephal K Doshi, Saibal Kar, Douglas N Gibson, Matthew J Price, Kenneth Huber, Rodney P Horton, Maurice Buchbinder, Petr Neuzil, Nicole T Gordon, David R Holmes
BACKGROUND: The PROTECT AF (WATCHMAN Left Atrial Appendage System for Embolic Protection in Patients With Atrial Fibrillation) trial demonstrated that left atrial appendage closure (LAAC) with the Watchman device (Boston Scientific, St. Paul, Minnesota) was equivalent to warfarin for preventing stroke in atrial fibrillation, but had a high rate of complications. In a second randomized trial, PREVAIL (Evaluation of the WATCHMAN LAA Closure Device in Patients With Atrial Fibrillation Versus Long Term Warfarin Therapy), the complication rate was low...
November 4, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29102234/acute-treatment-of-stroke-due-to-spontaneous-calcified-cerebral-emboli-causing-large-vessel-occlusion
#17
REVIEW
Muhammad Faraz Raghib, Johannes Sebastian Mutzenbach, Cornelia Rösler, Ferdinand Otto, Mark Mc Coy, Erasmia Müller-Thies-Broussalis, Slaven Pikija
INTRODUCTION: Calcified cerebral emboli (CCE) are rarely responsible for large vessel occlusion (LVO) in acute anterior stroke, and therefore therapeutic experience is scarce. We sought to expand current knowledge upon therapeutic options with three new cases and a review of current literature. METHODS: Systematic search of patients with acute anterior stroke due to LVO in one comprehensive stroke center throughout a 4 year period. Literature search for reported cases of CCE...
October 25, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29101545/-recent-and-upcoming-randomized-trials-for-left-atrial-appendage-occlusion-need-for-a-definite-assessment-of-the-situation
#18
REVIEW
Carsten Skurk, Johannes Jakob Hartung, Ulf Landmesser
Atrial fibrillation (AF) is the most common arrhythmia affecting more than 1.6 million patients in Germany. Based on demographic developments, an the number is expected to increase. Embolic strokes in AF patients are particularly severe, and individualized new oral anticoagulant (NOAC) therapy reduces the incidence of stroke in these patients by approximately 70%. Besides vitamin K antagonists, the NOACs rivaroxaban, dabigatran, apixaban, and edoxaban have been introduced into clinical practice; however, major bleeding still occurs at a rate of 2-3% per year...
November 3, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29101544/anatomy-of-the-atria-a%C3%A2-road-map-to-the-left-atrial-appendage
#19
REVIEW
Umberto Barbero, Siew Yen Ho
The left atrial appendage (LAA) has received increasing attention in recent years because of thrombi formation in patients with atrial fibrillation, which increases the risk of stroke. In patients who have contraindications for long-term oral anticoagulation therapy, percutaneous procedures are used to occlude the LAA and there are now several devices available for implantation, both endocardially and epicardially. Despite the high-resolution imaging techniques on hand today, limitations remain in providing information about wall thickness and neighboring structures; therefore, in-depth knowledge of the normal atrial anatomy is mandatory when considering such interventions...
November 3, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29091870/immunotherapy-for-acute-myeloid-leukemia-aml-a-potent-alternative-therapy
#20
REVIEW
Desmond O Acheampong, Christian K Adokoh, Du-Bois Asante, Ernest A Asiamah, Prince A Barnie, Dan O M Bonsu, Foster Kyei
The standard therapy of AML for many years has been chemotherapy with or without stem transplantation. However, there has not been any tangible improvement in this treatment beyond induction through chemotherapy and consolidation with allogeneic stem cell transplantation or chemotherapy. Residual AML cells which later cause relapse mostly persist even after rigorous standard therapy. It is imperative therefore to find an alternative therapy that can take care of the residual AML cells. With a better understanding of how the immune system works to destroy tumor cells and inhibit their growth, another therapeutic option immunotherapy has emerged to address the difficulties associated with the standard therapy...
October 26, 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
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