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Watchman LAA

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https://www.readbyqxmd.com/read/28128883/early-canadian-multi-center-experience-with-watchman-for-percutaneous-left-atrial-appendage-closure
#1
Jacqueline Saw, Peter Fahmy, Lorenzo Azzalini, Jean-Francois Marquis, Benjamin Hibbert, Carlos Morillo, Aldo Carrizo, Reda Ibrahim
BACKGROUND: There is limited data with WATCHMAN for left atrial appendage (LAA) closure in patients with non-valvular atrial fibrillation (AF) and contraindications to anticoagulation. The purpose of this study was to evaluate the safety and efficacy of WATCHMAN in our early Canadian experience. METHODS: We report our pooled consecutive series of patients who underwent WATCHMAN implantation at 4 major Canadian centers. Indications for LAA closure were CHADS2 ≥ 1 or CHA2 DS2 -VASc ≥ 2, and contraindication/intolerance to or failure on anticoagulation...
January 27, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28070743/cardiac-ct-angiography-ccta-predicts-left-atrial-appendage-occluder-device-size-and-procedure-outcome
#2
Orly Goitein, Noam Fink, Ilan Hay, Elio Di Segni, Victor Guetta, David Goitein, Yafim Brodov, Eli Konen, Michael Glikson
AIM: To investigate the role of cardiac CT angiography (CCTA) in predicting optimal left atrial appendage (LAA) occluder size and procedure outcome. METHODS AND RESULTS: Thirty-six patients underwent pre-procedural CCTA. CCTA and TEE LAA orifice diameters and perimeters were compared with the implanted device size. CCTA 3D configuration was correlated with procedure outcome. Watchman™ device (N = 18): diameters were 21 ± 4, 26 ± 5 and 25 ± 3 mm for TEE, CCTA and inserted device, respectively...
January 9, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28013284/ct-sizing-for-left-atrial-appendage-closure-is-associated-with-favourable-outcomes-for-procedural-safety
#3
Adil Rajwani, Adam J Nelson, Masoumeh G Shirazi, Patrick J S Disney, Karen S L Teo, Dennis T L Wong, Glenn D Young, Stephen G Worthley
AIMS: We evaluated the utility of computerized tomography (CT) with respect to sizing work-up for percutaneous left atrial appendage (LAA) closure, and implications for procedural safety and outcomes. METHODS AND RESULTS: Contrast-enhanced multi-detector CT was routinely conducted to guide sizing for LAA closure in addition to transoesophageal echocardiography (TOE). Procedural safety and efficacy were prospectively assessed. Across 73 consecutive cases there were no device-related procedural complications, and no severe leaks...
December 24, 2016: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/27943538/catheter-ablation-for-atrial-fibrillation-in-patients-with-watchman-left-atrial-appendage-occlusion-device-results-from-a-multicenter-registry
#4
Mohit K Turagam, Madhav Lavu, Muhammad R Afzal, Venkat Vuddanda, Mohammad-Ali Jazayeri, Valay Parikh, Donita Atkins, Sudharani Bommana, Luigi DI Biase, Rodney Horton, Rong Bai, Vijay Swarup, Jie Cheng, Andrea Natale, Dhanunjaya Lakkireddy
BACKGROUND: There have been an increasing number of atrial fibrillation (AF) patients with Watchman left atrial appendage occlusion (LAAO) device, requiring catheter ablation (CA) for maintenance of normal sinus rhythm. In this study, we describe our experience with the feasibility and safety of CA in patients with a preexisting Watchman LAAO device. METHODS: This was a retrospective multicenter AF registry of 60 patients with Watchman LAAO device who underwent CA for AF...
February 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/27884358/application-of-3-dimensional-computed-tomographic-image-guidance-to-watchman-implantation-and-impact-on%C3%A2-early-operator-learning-curve-single-center-experience
#5
Dee Dee Wang, Marvin Eng, Daniel Kupsky, Eric Myers, Michael Forbes, Mehnaz Rahman, Mohammad Zaidan, Sachin Parikh, Janet Wyman, Milan Pantelic, Thomas Song, Jeff Nadig, Patrick Karabon, Adam Greenbaum, William O'Neill
OBJECTIVES: The aim of this study was to examine the impact of 3-dimensional (3D) computed tomographic (CT) guided procedural planning for left atrial appendage (LAA) occlusion on the early operator WATCHMAN learning curve. BACKGROUND: Traditional WATCHMAN implantation is dependent on 2-dimensional transesophageal echocardiographic (TEE) sizing and intraprocedural guidance. METHODS: LAA occlusion with the WATCHMAN device was performed in 53 patients...
November 28, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27815629/pulmonary-artery-perforation-and-coronary-air-embolism-two-fatal-outcomes-in-percutaneous-left-atrial-appendage-occlusion
#6
J Zwirner, R Bayer, C Hädrich, A Bollmann, N Klein, J Dreßler, B Ondruschka
Percutaneous left atrial appendage (LAA) closure is a routinely performed method to reduce the risk of stroke in patients suffering from atrial fibrillation, when an oral anticoagulation is no longer indicated due to relevant bleeding complications. Currently, the Amplatzer Amulet and the Watchman system are two equally used systems. While there is an acute success rate of more than 95 per cent for this intervention, several minor and major complications such as pericardial effusions, air embolism, vascular lesions in proximity to the heart or even death can occur...
January 2017: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/27696317/left-atrial-appendage-closure-for-stroke-prevention-in-atrial-fibrillation
#7
REVIEW
Erin A Fender, Jawad G Kiani, David R Holmes
PURPOSE OF REVIEW: Anticoagulant therapy effectively reduces the incidence of stroke in patients with atrial fibrillation (AF) but is underutilized and frequently contraindicated. The left atrial appendage (LAA) is the primary site of thrombus formation in AF patients. Surgical and percutaneous appendage closure has been evaluated as a site-specific therapy to reduce systemic thromboembolism. RECENT FINDINGS: We will review LAA closure techniques, examine recent outcome data, and discuss the indications for, and potential complications of, each approach...
November 2016: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/27679417/retrieval-of-embolized-left-atrial-appendage-devices
#8
Peter Fahmy, Lim Eng, Jacqueline Saw
Percutaneous left atrial appendage (LAA) closure is gaining interest as an alternative option for prevention of strokes in patients with Atrial Fibrillation (AF), especially for those with contraindications to anticoagulation. Complications from these procedures are well described in the medical literature. LAA closures may lead to pericardial effusion, device-associated thrombus, and device embolization. Understanding the reasons for embolization, strategies to avoid embolization, and the techniques for retrieval of LAA devices (ACP/AMULET and WATCHMAN) should be appreciated by endovascular implanters...
September 28, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27621674/percutaneous-left-atrial-appendage-closure-devices-safety-efficacy-and-clinical-utility
#9
REVIEW
Martin J Swaans, Lisette Is Wintgens, Arash Alipour, Benno Jwm Rensing, Lucas Va Boersma
Atrial fibrillation (AF) is the most common arrhythmia treated in the clinical practice. One of the major complications of AF is a thromboembolic cerebral ischemic event. Up to 20% of all strokes are caused by AF. Thromboembolic cerebral ischemic event in patients with AF occurs due to atrial thrombi, mainly from the left atrial appendage (LAA). Prevention of clot formation with antiplatelet agents and especially oral anticoagulants (vitamin K antagonists or newer oral anticoagulants) has been shown to be effective in reducing the stroke risk in patients with AF but has several drawbacks with (major) bleedings as the most important disadvantage...
2016: Medical Devices: Evidence and Research
https://www.readbyqxmd.com/read/27594651/initial-experience-with-the-watchman%C3%A2-left-atrial-appendage-system-for-stroke-prevention-in-atrial-fibrillation-a-single-centre-registry
#10
Guillaume Bonnet, Erwan Salaun, Mathieu Pankert, Thomas Cuisset, Jean-Louis Bonnet
BACKGROUND: Left atrial appendage (LAA) closure using the WATCHMAN™ device (WM) may be considered in patients with non-valvular atrial fibrillation (AF) and a high-risk of stroke who are ineligible for long-term oral anticoagulation (OAC). AIM: To report our single-centre preliminary experience, focusing on feasibility, safety and short-term efficacy of this procedure. METHODS: Patients implanted from December 2013 to February 2014 were included...
December 2016: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/27567013/left-atrial-appendage-closure-a-single-center-experience-and-comparison-of-two-contemporary-devices
#11
Filippo Figini, Patrizio Mazzone, Damiano Regazzoli, Giulia Porata, Neil Ruparelia, Francesco Giannini, Stefano Stella, Francesco Ancona, Eustachio Agricola, Nicoleta Sora, Alessandra Marzi, Andrea Aurelio, Nicola Trevisi, Paolo Della Bella, Antonio Colombo, Matteo Montorfano
OBJECTIVES: To compare indications and clinical outcomes of two contemporary left atrial appendage (LAA) percutaneous closure systems in a "real-world" population. BACKGROUND: Percutaneous LAA occlusion is an emerging therapeutic option for stroke prevention in atrial fibrillation. Some questions however remain unanswered, such as the applicability of results of randomized trials to current clinical practice. Moreover, currently available devices have never been directly compared...
August 27, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27537503/the-value-of-3d-printing-models-of-left-atrial-appendage-using-real-time-3d-transesophageal-echocardiographic-data-in-left-atrial-appendage-occlusion-applications-toward-an-era-of-truly-personalized-medicine
#12
Peng Liu, Rijing Liu, Yan Zhang, Yingfeng Liu, Xiaoming Tang, Yanzhen Cheng
AIMS AND OBJECTIVES: The objective of this study was to assess the clinical feasibility of generating 3D printing models of left atrial appendage (LAA) using real-time 3D transesophageal echocardiogram (TEE) data for preoperative reference of LAA occlusion. BACKGROUND: Percutaneous LAA occlusion can effectively prevent patients with atrial fibrillation from stroke. However, the anatomical structure of LAA is so complicated that adequate information of its structure is essential for successful LAA occlusion...
August 19, 2016: Cardiology
https://www.readbyqxmd.com/read/27476858/learning-curve-assessment-for-percutaneous-left-atrial-appendage-closure-with-the-watchman-occluder
#13
Jakob Ledwoch, Christine Krollmann, Stephan Staubach, Martin Hug, Henning Strohm, Harald Mudra
OBJECTIVES: We sought to evaluate the effect of increasing experience with left atrial appendage (LAA) closure on short-term outcome. BACKGROUND: Data regarding the impact of the learning curve of LAA closure-particularly regarding technical aspects of the procedure-are lacking. METHODS: The present analysis represents first data from a single-center all-comer registry. The population was divided into 3 groups according to treatment time (group 1: patients 1-30; group 2: patients 31-60; group 3: patients 61-90)...
August 2016: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/27407055/effectiveness-of-left-atrial-appendage-exclusion-procedures-to-reduce-the-risk-of-stroke-a-systematic-review-of-the-evidence
#14
North Noelck, Joel Papak, Michele Freeman, Robin Paynter, Allison Low, Makalapua Motu'apuaka, Karli Kondo, Devan Kansagara
BACKGROUND: Atrial fibrillation is an important cause of cardioembolic stroke. Oral anticoagulants (OAC) reduce stroke risk but increase the risk of serious bleeding. Left atrial appendage (LAA) procedures have been developed to isolate the LAA from circulating blood flow, as an alternative to OAC. We conducted a systematic review of the benefits and harms of surgical and percutaneous LAA exclusion procedures. METHODS AND RESULTS: We searched multiple data sources, including Ovid MEDLINE, Cochrane, and Embase, through January 7, 2015...
July 2016: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/27404716/preclinical-assessment-of-a-modified-occlutech-left-atrial-appendage-closure-device-in-a-canine-model
#15
Jung-Sun Kim, Seul-Gee Lee, Sung-Kyung Bong, Se-Il Park, Sung-Yu Hong, Sanghoon Shin, Chi Young Shim, Geu-Ru Hong, Donghoon Choi, Yangsoo Jang, Jai-Wun Park
BACKGROUND: LAA occlusion has a similar stroke prevention efficacy compared to anticoagulation treatment for non-valvular atrial fibrillation. OBJECTIVE: The objective of this study was to assess the feasibility and safety of a modified Occlutech® left atrial appendage (LAA) closure device in a canine model. METHODS: The device was implanted in 10 dogs (33±1kg) using fluoroscopy and transesophageal echocardiography (TEE) guidance. The modified Occlutech® LAA occlusion device was compared with the current version, the Watchman device, and the Amplazter cardiac plug (ACP)...
October 15, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27402623/concomitant-cryoballoon-ablation-and-percutaneous-closure-of-left-atrial-appendage-in-patients-with-atrial-fibrillation
#16
Gaetano Fassini, Sergio Conti, Massimo Moltrasio, Anna Maltagliati, Fabrizio Tundo, Stefania Riva, Antonio Dello Russo, Michela Casella, Benedetta Majocchi, Martina Zucchetti, Eleonora Russo, Vittoria Marino, Mauro Pepi, Claudio Tondo
AIMS: Pulmonary veins (PVs) isolation is the cornerstone of atrial fibrillation (AF) ablation and can be achieved either by conventional radiofrequency ablation or by cryoenergy. Left atrial appendage (LAA) closure has been proposed as alternative treatment to vitamin K antagonists (VKA). We aimed to evaluate the feasibility of combining cryoballoon (CB) ablation and LAA occlusion in patients with AF and a high thromboembolic risk or contraindication to antithrombotic therapy. METHODS AND RESULTS: Thirty-five patients (28 males, 74 ± 2 years) underwent CB ablation...
November 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27343417/prospective-randomized-evaluation-of-the-watchman-left-atrial-appendage-closure-device-in-patients-with-atrial-fibrillation-versus-long-term-warfarin-therapy-the-prevail-trial
#17
REVIEW
Djouhar Roufeida Belgaid, Zara Khan, Mariam Zaidi, Adrian Hobbs
OBJECTIVES: Assessing the safety and effectiveness of left atrial appendage (LAA) (pouch found in the upper chambers of the heart) occlusion, using the Watchman device compared to long term warfarin therapy (drug that reduces clot formation), in preventing the risk of stroke in patients with atrial fibrillation (most common type of irregular heart beat). 90% of strokes in atrial fibrillation arise from clots forming in this pouch. By mechanically blocking it using the device less clots are suggested to be formed...
September 15, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27307517/cost-effectiveness-of-percutaneous-closure-of-the-left-atrial-appendage-in-atrial-fibrillation-based-on-results-from-protect-af-versus-prevail
#18
James V Freeman, David W Hutton, Geoffrey D Barnes, Ruo P Zhu, Douglas K Owens, Alan M Garber, Alan S Go, Mark A Hlatky, Paul A Heidenreich, Paul J Wang, Amin Al-Ahmad, Mintu P Turakhia
BACKGROUND: Randomized trials of left atrial appendage (LAA) closure with the Watchman device have shown varying results, and its cost effectiveness compared with anticoagulation has not been evaluated using all available contemporary trial data. METHODS AND RESULTS: We used a Markov decision model to estimate lifetime quality-adjusted survival, costs, and cost effectiveness of LAA closure with Watchman, compared directly with warfarin and indirectly with dabigatran, using data from the long-term (mean 3...
June 2016: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/27131771/does-left-atrial-appendage-laa-occlusion-device-alter-the-echocardiography-and-electrocardiogram-parameters-in-patients-with-atrial-fibrillation
#19
Qiqiang Jie, Dongzhi Wang, Baoxin Liu, Dongdong Zhao, Yong Li, Jiachen Luo, Liming Dai, Shuang Li, Yawei Xu, Yidong Wei
BACKGROUND: The alterations of echocardiography and electrocardiogram (ECG) in patients received left atrial appendage LAA occlusion therapy are still unclear. The present study was to evaluate the influence of LAA occlusion device on echocardiography and ECG changes in patients with atrial fibrillation (AF). METHODS: Seventy-three patients who had undergone Watchman, LAmbre and Lefort were enrolled in this study. Echocardiography and ECG results at pre- and post-operation were collected...
July 15, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27092193/combined-catheter-ablation-for-atrial-fibrillation-and-watchman%C3%A2-left-atrial-appendage-occlusion-procedures-five-year-experience
#20
Karen P Phillips, Daniel T Walker, Julie A Humphries
BACKGROUND: Patients with atrial fibrillation (AF) may benefit from undergoing concomitant interventions of left atrial catheter ablation and device occlusion of the left atrial appendage (LAA) as a two-pronged strategy for rhythm control and stroke prevention. We report on the outcome of combined procedures in a single center case series over a 5-year timeframe. METHODS: Ninety-eight patients with non-valvular AF and a mean CHA2DS2-VASc score 2.6±1.0 underwent either first time, or redo pulmonary vein isolation (PVI) procedures, followed by successful implant of a Watchman® device...
April 2016: Journal of Arrhythmia
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