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https://www.readbyqxmd.com/read/29463510/device-thrombosis-after-percutaneous-left-atrial-appendage-occlusion-is-related-to-patient-and-procedural-characteristics-but-not-to-duration-of-postimplantation-dual-antiplatelet-therapy
#1
Radoslaw Pracon, Sripal Bangalore, Zofia Dzielinska, Marek Konka, Cezary Kepka, Mariusz Kruk, Edyta Kaczmarska-Dyrda, Joanna Petryka-Mazurkiewicz, Sebastian Bujak, Mateusz Solecki, Agnieszka Pskit, Agnieszka Dabrowska, Bartosz Sieradzki, Andrzej Plonski, Witold Ruzyllo, Adam Witkowski, Marcin Demkow
BACKGROUND: Device-related thrombus (DRT) after left atrial appendage occlusion is a worrisome finding with little knowledge about when to expect it and how to prevent it. This study sought to investigate correlates of DRT after left atrial appendage occlusion, its time of diagnosis, and particularly, association with postimplantation dual antiplatelet therapy duration. METHODS AND RESULTS: Consecutive patients (n=102) after left atrial appendage occlusion with AMPLATZER Cardiac Plug/Amulet (n=59) or WATCHMAN (n=43) were included in a prospective registry (October 2011-May 2016)...
March 2018: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29454726/successful-percutaneous-retrieval-of-a-33-mm-watchman-left-atrial-appendage-occlusion-device-from-the-left-atrium
#2
Hai-Ying Li, Xin-Lei Wu, Fang-Yi Xiao, Xiao-Dong Zhou, Ye Chen, Wei-Jian Huang
No abstract text is available yet for this article.
February 8, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29453694/percutaneous-left-atrial-appendage-occlusion-in-the-prevention-of-stroke-in-atrial-fibrillation-a-systematic-review
#3
REVIEW
Jayson R Baman, Moussa Mansour, E Kevin Heist, David T Huang, Yitschak Biton
Atrial fibrillation is commonly coexistent with heart failure, and the management of the heart failure patient would be incomplete without an appreciation for atrial fibrillation management. There are many complications associated with oral anticoagulation in the prevention of stroke related to atrial fibrillation. In recent years, the advent of several percutaneous left atrial appendage (LAA) occlusion/closure strategies has sought to provide an alternative treatment modality. Here, we systematically review the published literature to investigate the efficacy and safety of percutaneous LAA occlusion/closure devices...
February 17, 2018: Heart Failure Reviews
https://www.readbyqxmd.com/read/29453212/implant-of-a-left-atrial-appendage-occluder-device-watchman-and-leadless-pacing-system-micra-through-the-same-venous-access-in-a-single-sitting
#4
Sofian Johar, Nazar Luqman
A left atrial appendage occluder device (Watchman) and leadless pacemaker (Micra) was implanted from a single right femoral vein access in a 73-year-old female patient with persistent atrial fibrillation and symptomatic tachy-brady syndrome and unable to take oral anticoagulants. Standard methods of implantation were followed for both procedures. The Watchman device was implanted first followed by dilatation of the same venous access site in order to implant Micra transcatheter pacing system. The patient tolerated the procedures well and there were no complications...
February 16, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29415203/left-atrial-appendage-patency-and-device-related-thrombus-after-percutaneous-left-atrial-appendage-occlusion-a-computed-tomography-study
#5
Hubert Cochet, Xavier Iriart, Soumaya Sridi, Claudia Camaioni, Olivier Corneloup, Michel Montaudon, François Laurent, Wieme Selmi, Pauline Renou, Zakaria Jalal, Jean-Benoît Thambo
Aims: Transoesophageal echocardiography studies have reported frequent peri-device leaks and device-related thrombi (DRT) after percutaneous left atrial appendage (LAA) occlusion. We assessed the prevalence, characteristics and correlates of leaks and DRT on cardiac computed tomography (CT) after LAA occlusion. Methods and results: Consecutive patients underwent cardiac CT before LAA occlusion to assess left atrial (LA) volume, LAA shape, and landing zone diameter...
February 2, 2018: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/29411147/atrial-fibrillation-for-the-neurologist-preventing-both-ischemic-and-hemorrhagic-strokes
#6
REVIEW
Elif Gokcal, Marco Pasi, Marc Fisher, M Edip Gurol
PURPOSE OF REVIEW: This review aims to help neurologists managing atrial fibrillation (AF) patients who had an ischemic stroke and/or with intracranial hemorrhage (ICH) markers, therefore at high embolic/hemorrhagic risks. RECENT FINDINGS: Implantable loop recorders have substantially improved the accuracy of AF detection. Recent research yielded a set of powerful neuroimaging markers that can stratify ICH risk. Direct oral anticoagulants (DOAC) are easier to use with a lower ICH risk than warfarin in a general AF population...
February 6, 2018: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/29385439/emergent-surgical-removal-of-a-migrated-left-atrial-appendage-occluder
#7
Mohamed El-Gabry, Sharaf-Eldin Shehada, Daniel Wendt, Fanar Mourad
Occlusion of the left atrial appendage (LAA) in patients with atrial fibrillation has become a standard therapy to prevent thromboembolic complications. We aim to present 3 cases of LAA occluder embolization after percutaneous WATCHMAN™ device implantation, which required emergent surgical retrieval. The device was dislocated in the left atrium, introducing LAA perforation and resulting in pericardial effusion and later tamponade in 1 patient who developed multiorgan failure and died 8 days postoperatively...
January 29, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29381951/watchman-device-related-thrombus-successfully-treated-with-apixaban-a-case-report
#8
Chun-Ka Wong, Pak-Hei Chan, Cheung-Chi Lam, On-Hing Kwok, Yat-Yin Lam, Chung-Wah Siu
RATIONALE: Among atrial fibrillation patients with high risk of bleeding, left atrial appendage occlusion has emerged as an alternative to long-term oral anticoagulation therapy for stroke prevention. Device-related thrombus remains a major concern because it may result in recurrent embolic events. To date, there is no consensus on the optimal method of treating device-related-thrombus. PATIENT CONCERNS: A 78-year-old man with atrial fibrillation had an episode of intracranial hemorrhage while taking warfarin...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29379717/cryoballoon-pulmonary-vein-isolation-and-voltage-mapping-for-symptomatic-atrial-fibrillation-9-months-after-watchman-device-implantation
#9
Henry D Huang, Viren M Patel, Parikshit S Sharma, Zenith Jameria, Sorin Lazar, Richard Trohman, Erik Wissner
No abstract text is available yet for this article.
January 2018: HeartRhythm Case Reports
https://www.readbyqxmd.com/read/29374188/impact-of-left-atrial-appendage-morphology-on-thrombus-formation-after-successful-left-atrial-appendage-occlusion-assessment-with-cardiac-computed-tomography
#10
Wulf Dieker, Michael Behnes, Christian Fastner, Benjamin Sartorius, Annika Wenke, Ishar Sing-Gill, Ibrahim El-Battrawy, Jürgen Kuschyk, Theano Papavassiliu, Ursula Hoffmann, Kambis Mashayekhi, Stefan O Schoenberg, Martin Borggrefe, Thomas Henzler, Ibrahim Akin
A standardized imaging algorithm by cardiac computed tomography angiography (cCTA) (LOVE-view) was used in 30 patients to evaluate the influence of different left atrial appendage (LAA) morphologies on development of thrombosis in the LAA 6 months after implantation of an occlusion device (Watchman or Amplatzer-Cardiac-Plug) in patients with non-valvular atrial fibrillation, CHA2DS2-VASc-Score >1 and a contraindication for oral anticoagulation. The distribution of different LAA morphologies was 40% windsock, 17% broccoli and 43% chicken wing type...
January 26, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29350390/dual-antiplatelet-therapy-is-safe-and-efficient-after-left-atrial-appendage-closure
#11
Jakub Maksym, Tomasz Mazurek, Janusz Kochman, Marek Grygier, Agnieszka Kapłon-Cieślicka, Michał Marchel, Piotr Lodziński, Radosław Piątkowski, Radosław Wilimski, Paweł Czub, Anna Fojt, Natalia Karolczak, Piotr Hendzel, Grzegorz Opolski
BACKGROUND: Despite of PROTECT AF trial results many patients undergoing left atrial appendage closure (LAAC) have unconditional contraindications to warfarin. AIM: We sought to investigate whether double antiplatelet therapy (DAPT) is safe in patients after LAAC. METHODS: 44 (22 males, mean age 74±7.8) consecutive patients with non-valvular atrial fibrillation (NVAF) underwent LAAC procedure using Watchman device followed by DAPT (75 mg Aspirin and 75 mg Clopidogrel)...
January 19, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29313819/real-world-safety-and-efficacy-of-watchman-laa-closure-at-one-year-in-patients-on-dual-antiplatelet-therapy-results-of-the-dapt-subgroup-from-the-ewolution-all-comers-study
#12
Martin W Bergmann, Hüseyin Ince, Stephan Kische, Thomas Schmitz, Felix Meincke, Boris Schmidt, David Foley, Timothy R Betts, Marek Grygier, Alexey V Protopopov, Kenneth M Stein, Lucas V A Boersma
AIMS: The study aims to confirm efficacy and safety of WATCHMAN LAA closure in AF patients unsuitable for oral anticoagulation. METHODS AND RESULTS: The EWOLUTION registry prospectively collects all clinical data on 1005 European patients implanted with a WATCHMAN device. Following the procedure, 605 patients (60.2%) received dual antiplatelet therapy according to the local standard; DAPT was discontinued in 85% of pts within 1 year. CHA2DS2-VASc and HAS-BLED scores were 4...
January 9, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29297907/-combined-left-atrial-appendage-percutaneous-closure-and-atrial-fibrillation-ablation-a-single-center-experience
#13
Elisa Pelissero, Marco Giuggia, Maria Chiara Todaro, Giuseppe Trapani, Benedetta Giordano, Gaetano Senatore
BACKGROUND: We evaluated long-term safety and efficacy of concomitant left atrial appendage (LAA) closure and atrial fibrillation (AF) ablation. METHODS: From February 2013 to June 2017, all patients referred for AF ablation and LAA closure (group 1) were enrolled in the study and compared with a matched control group undergoing AF ablation only (group 2). Pulmonary vein isolation was achieved in all cases with radiofrequency or cryoballoon. LAA was occluded with Watchman or Amplatzer Cardiac Plug or Amulet (ACP) devices...
December 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/29233088/left-atrial-enlargement-and-clinical-considerations-in-patients-with-or-without-a-residual-interatrial-shunt-after-closure-of-the-left-atrial-appendage-with-the-watchman%C3%A2-device
#14
Blerim Luani, Thomas Groscheck, Conrad Genz, Ivan Tanev, Thomas Rauwolf, Joerg Herold, Senad Medunjanin, Alexander Schmeisser, Rüdiger C Braun-Dullaeus
BACKGROUND: Interventional closure of the left atrial appendage (LAA) in patients with non-valvular atrial fibrillation, high thromboembolic and bleeding risk or bleeding history is an alternative therapeutic strategy to oral anticoagulation. It is not known if the exclusion of the LAA from the blood circulation affects the left atrial volume (LAV) and consequently its prognostic value or the circulatory performance of the heart in humans. METHODS: We aimed to prospectively assess potential changes in baseline LAV, left ventricular ejection fraction (LVEF), NT-proBNP-level and the covered distance in the 6-min walk-test 6 weeks and 6 months after LAA closure with the WATCHMAN™ device...
December 12, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29223726/computed-tomography-measurement-of-the-left-atrial-appendage-for-optimal-sizing-of-the-watchman-device
#15
Bo Xu, Jorge Betancor, Kimi Sato, Serge Harb, Karim Abdur Rehman, Kunal Patel, Arnav Kumar, Paul C Cremer, Wael Jaber, L Leonardo Rodriguez, Paul Schoenhagen, Oussama Wazni
INTRODUCTION: Percutaneous left atrial appendage (LAA) occlusion is an emerging treatment option for patients with non-valvular atrial fibrillation who cannot tolerate oral anticoagulation. The Watchman device (Boston Scientific Corporation, Natick, MA, USA) is deployed at the ostium of the LAA, and an appropriately sized device is critical for successful occlusion. However, standardized imaging protocols for device sizing have not been established. OBJECTIVES: We investigated the clinical utility of a standardized imaging protocol, with pre-procedural multi-detector cardiac computed tomography (MDCT), and intra-procedural transesophageal echocardiography (TEE), for Watchman device sizing...
January 2018: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/29222738/ct-based-3d-printing-is-superior-to-transesophageal-echocardiography-for-pre-procedure-planning-in-left-atrial-appendage-device-closure
#16
Edinrin Obasare, Sumeet K Mainigi, D Lynn Morris, Leandro Slipczuk, Igor Goykhman, Evan Friend, Mary Rodriguez Ziccardi, Gregg S Pressman
Accurate assessment of the left atrial appendage (LAA) is important for pre-procedure planning when utilizing device closure for stroke reduction. Sizing is traditionally done with transesophageal echocardiography (TEE) but this is not always precise. Three-dimensional (3D) printing of the LAA may be more accurate. 24 patients underwent Watchman device (WD) implantation (71 ± 11 years, 42% female). All had complete 2-dimensional TEE. Fourteen also had cardiac computed tomography (CCT) with 3D printing to produce a latex model of the LAA for pre-procedure planning...
December 8, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/29194654/safety-and-efficacy-analysis-of-one-stop-intervention-for-treating-nonvalvular-atrial-fibrillation
#17
Hongde Hu, Kaijun Cui, Jian Jiang, Hua Fu, Rui Zeng
BACKGROUND: Nonvalvular atrial fibrillation (AF) is a common arrhythmia. The treatment strategy for AF mainly includes controlling symptoms and decreasing the rate of complications. Our study aimed to evaluate the safety and efficacy of combination treatment of catheter ablation and left atrial appendage (LAA) closure (one-stop intervention) in patients with nonvalvular AF. METHODS AND RESULTS: Thirty-four patients with symptomatic AF (mean CHA2 DS2 -VASc score 4...
November 30, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29158017/left-atrial-appendage-occlusion-exclusion-procedural-image-guidance-with-transesophageal-echocardiography
#18
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/29130638/thromboembolism-after-watchman-tm-in-a-clopidogrel-non-responder-a-case-for-concern
#19
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/29106523/combining-watchman-left-atrial-appendage-closure-and-catheter-ablation-for-atrial-fibrillation-multicentre-registry-results-of-feasibility-and-safety-during-implant-and-30-days-follow-up
#20
Karen P Phillips, Evgeny Pokushalov, Aleksandr Romanov, Sergey Artemenko, Richard J Folkeringa, Tamas Szili-Torok, Gaetano Senatore, Kenneth M Stein, Omar Razali, Nicole Gordon, Lucas V A Boersma
Aims: Long-term results from catheter ablation therapy for atrial fibrillation (AF) remain uncertain and clinical practice guidelines recommend continuation of long-term oral anticoagulation in patients with a high stroke risk. Left atrial appendage closure (LAAC) with Watchman has emerged as an alternative to long-term anticoagulation for patients accepting of the procedural risks. We report on the initial results of combining catheter ablation procedures for AF and LAAC in a multicentre registry...
July 3, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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