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REVIEW
Jakub Maksym, Marcin Grabowski, Tomasz Mazurek
Atrial fibrillation (AF) is the most commonly observed arrhythmia in the world and its prevalence increases with age. The main and most severe complication of AF is ischemic stroke. Oral anticoagulation (OAC) therapy is the standard of care for stroke prevention in the high risk population. Initiation of this treatment is associated with a substantial risk of bleeding complications. Moreover, there is a group of patients who cannot tolerate OAC. In patients with AF the left atrial appendage (LAA) is the main source of thrombus formation...
March 2024: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
#2
JOURNAL ARTICLE
Thoracoscopic Left Atrial Appendage Occlusion with the AtriClip PRO2: An Experience of 144 Patients.
Edward Wang, Paul Sadleir, Vijay Sourinathan, Rukshen Weerasooriya, David Playford, Pragnesh Joshi
AIM: To report the clinical outcomes of thoracoscopic left atrial appendage occlusion (LAAO) with the AtriClip PRO2 device (Atricure Inc, Mason, OH, USA). Stroke risk reduction with LAAO in patients with atrial fibrillation is now well-established. Many surgical and percutaneous techniques have been used, with varying rates of success. The percutaneous devices have had issues with procedural complications and peridevice flow. Thoracoscopic AtriClip offers an epicardial linear closure of the appendage at its ostium...
April 10, 2024: Heart, Lung & Circulation
#3
REVIEW
Saverio Continisio, Carolina Montonati, Filippo Angelini, Pier Paolo Bocchino, Carla Carbonaro, Federico Giacobbe, Veronica Dusi, Ovidio De Filippo, Alfonso Ielasi, Giuseppe Giannino, Emiliano Boldi, Tommaso Fabris, Fabrizio D'Ascenzo, Gaetano Maria De Ferrari, Giuseppe Tarantini
BACKGROUND: In the last few years, percutaneous LAA occlusion (LAAO) has become a plausible alternative in atrial fibrillation (AF) patients with contraindications to anticoagulation therapy. Nevertheless, the optimal antiplatelet strategy following percutaneous LAAO remains to be defined. METHODS: Studies comparing single antiplatelet therapy (SAPT) versus dual antiplatelet therapy (DAPT) following LAAO were systematically searched and screened. The outcomes of interest were ischemic stroke, device-related thrombus (DRT) and major bleeding...
April 10, 2024: European Journal of Clinical Investigation
#4
JOURNAL ARTICLE
Houtan Heidari, Dominika Kanschik, Oliver Maier, Georg Wolff, Maximilian Brockmeyer, Maryna Masyuk, Raphael Romano Bruno, Amin Polzin, Ralf Erkens, Gerald Antoch, Sebastian Daniel Reinartz, Nikos Werner, Malte Kelm, Tobias Zeus, Shazia Afzal, Christian Jung
BACKGROUND: Understanding complex cardiac anatomy is essential for percutaneous left atrial appendage (LAA) closure. Conventional multi-slice computed tomography (MSCT) and transesophageal echocardiography (TEE) are now supported by advanced 3D printing and virtual reality (VR) techniques for three-dimensional visualization of volumetric data sets. This study aimed to investigate their added value for LAA closure procedures. METHODS: Ten patients scheduled for interventional LAA closure were evaluated with MSCT and TEE...
2024: Frontiers in Cardiovascular Medicine
#5
RANDOMIZED CONTROLLED TRIAL
Dhanunjaya R Lakkireddy, David J Wilber, Suneet Mittal, David Tschopp, Christopher R Ellis, Abdi Rasekh, Troy Hounshell, Rudy Evonich, Sheetal Chandhok, Ronald D Berger, Rodney Horton, Michael H Hoskins, Hugh Calkins, Steven J Yakubov, Pamela Simons, Benjamin R Saville, Randall J Lee
IMPORTANCE: Left atrial appendage elimination may improve catheter ablation outcomes for atrial fibrillation. OBJECTIVE: To assess the safety and effectiveness of percutaneous left atrial appendage ligation adjunctive to catheter pulmonary vein isolation for nonparoxysmal atrial fibrillation. DESIGN, SETTING, AND PARTICIPANTS: This multicenter, prospective, open-label, randomized clinical trial evaluated the safety and effectiveness of percutaneous left atrial appendage ligation adjunctive to planned pulmonary vein isolation for nonparoxysmal atrial fibrillation present for less than 3 years...
April 2, 2024: JAMA
#6
JOURNAL ARTICLE
Dominika Kanschik, Houtan Heidari, Kathrin Klein, Amin Polzin, Verena Veulemans, Jürgen Leick, Malte Kelm, Christian Jung, Tobias Zeus, Shazia Afzal
Due to the complex and variable anatomy of the left atrial appendage, percutaneous left atrial appendage closure (LAAC) can be challenging. In this study, we investigated the impact of fusion imaging (FI) on the LAAC learning curve of two interventionalists. The first interventionalist (IC 1) was initially trained without FI and continued his training with FI. The second interventionalist (IC 2) performed all procedures with FI. We compared the first 36 procedures without FI of IC 1 (group 1) with his next 36 interventions with FI (group 2)...
February 29, 2024: Journal of Cardiovascular Development and Disease
#7
JOURNAL ARTICLE
Sandeep K Goyal, Ashish A Bhimani, Danesh K Kella, Anahita Tyagi, Venkateshwar Polsani, Thomas F Deering
INTRODUCTION: Percutaneous left atrial appendage occlusion (LAAO) is traditionally performed under general anesthesia with trans-esophageal echocardiography guidance. Intracardiac echo (ICE)-guided LAAO closure is increasing in clinical use. The ICE catheter is crossed into LA via interatrial septum (IAS) after the septum is dilated with LAAO delivery sheath. This step can be time-consuming and requires significant ICE catheter manipulation, which increases the risk of cardiac perforation...
March 21, 2024: Journal of Cardiovascular Electrophysiology
#8
JOURNAL ARTICLE
Left atrial appendage occlusion: On the need of a numerical model to simulate the implant procedure.
Francesca Danielli, Francesca Berti, Benigno Marco Fanni, Emanuele Gasparotti, Simona Celi, Giancarlo Pennati, Lorenza Petrini
Left atrial appendage occlusion (LAAO) is a percutaneous procedure to prevent thromboembolism in patients affected by atrial fibrillation. Despite its demonstrated efficacy, the LAA morphological complexity hinders the procedure, resulting in postprocedural drawbacks (device-related thrombus and peri-device leakage). Local anatomical features may cause difficulties in the device's positioning and affect the effectiveness of the device's implant. The current work proposes a detailed FE model of the LAAO useful to investigate implant scenarios and derive clinical indications...
March 19, 2024: International Journal for Numerical Methods in Biomedical Engineering
#9
JOURNAL ARTICLE
Jan Gofus, Pavel Zacek, Youssef Shahin, Karel Medilek, Ludek Haman, Jan Vojacek
Prophylactic left atrial appendage occlusion has been suggested as a means of cardioembolism risk reduction in patients with atrial fibrillation. Its clinical benefits have been discussed together with potential endocrine or hemodynamic adverse effects, providing conflicting resolutions. We aimed to provide a thorough overview of the current literature and a recommendation for daily clinical decision making. A comprehensive Medline search through PubMed was utilized to search for relevant articles, further filtered by the title and abstract...
March 17, 2024: Kardiologia Polska
#10
JOURNAL ARTICLE
Ahmet Hakan Ates, Ahmet Kivrak, Ugur Nadir Karakulak, Cem Coteli, Hikmet Yorgun, Mehmet Levent Sahiner, Ergun Barıs Kaya, Kudret Aytemir
BACKGROUND: The study explores left atrial appendage closure (LAAC) as a safe and effective alternative to anticoagulation for atrial fibrillation (AF) patients at high bleeding risk. Complications, such as cardioembolic events due to left atrial appendage thrombus (LAAT), highlight the need for alternative stroke prevention strategies. AIMS: This research assesses LAAC's safety and efficacy in patients with LAAT, aiming to offer valuable insights into its potential as a viable option for stroke prevention in such cases...
March 13, 2024: Pacing and Clinical Electrophysiology: PACE
#11
JOURNAL ARTICLE
Yang-Qi Pan, Lu-Shen Jin, Sang Qian, Ting Jiang, Zhe-Ning Wang, Yi-Lian Chen, Yi-Xuan Qiu, Yi-Hao Wu, Jia-Yang Fu, Ling Li, Yuan-Nan Lin, Yue-Chun Li
Background and aim: Rivaroxaban is an emerging oral anticoagulant for postoperative anticoagulation after percutaneous left atrial appendage closure (LAAC). Because a once-daily dosing regimen of rivaroxaban causes fluctuations in the drug plasma concentration, we studied the feasibility and safety of twice-daily rivaroxaban as a postoperative anticoagulation regimen for patients with atrial fibrillation (AF) undergoing LAAC. Methods: This study involved patients with AF who underwent LAAC and took rivaroxaban postoperatively...
2024: Frontiers in Pharmacology
#12
JOURNAL ARTICLE
Sophie Eppinger, Kerstin Piayda, Roberto Galea, Marcus Sandri, Moniek Maarse, Ahmet Güner, Can Y Karabay, Ashish Pershad, Wern Y Ding, Adel Aminian, Ibrahim Akin, Karapet V Davtyan, Ivan A Chugunov, Eloi Marijon, Liesbeth Rosseel, Thomas Robert Schmidt, Nicolas Amabile, Kasper Korsholm, Juha Lund, Enio Guerios, Ignacio J Amat-Santos, Giacomo Boccuzzi, Christopher R Ellis, Avi Sabbag, Henning Ebelt, Brian Clapp, Hana Vaknin Assa, Amos Levi, Jakob Ledwoch, Sonja Lehmann, Oh-Hyun Lee, George Mark, Wendy Schell, Domenico G Della Rocca, Andrea Natale, Ole de Backer, Joelle Kefer, Pablo P Esteban, Mark Abelson, Pradhum Ram, Pamela Moceri, Jose G Galache Osuna, Xavier Millán Alvarez, Ignacio Cruz-Gonzalez, Tom de Potter, Moubarak Ghassan, Andrey Osadchiy, Weita Chen, Sandeep K Goyal, Francesco Giannini, Máximo Rivero-Ayerza, Shazia Afzal, Christian Jung, Carsten Skurk, Martin Langel, Mark Spence, Evgeny Merkulov, Mathieu Lempereur, Seung Y Shin, Jules Mesnier, Heather L McKinney, Brian T Schuler, Sebastien Armero, Livia Gheorghe, Marco B M Ancona, Lino Santos, Jacques Mansourati, Luis Nombela-Franco, Francesco Nappi, Michael Kühne, Achille Gaspardone, Jesper van der Pals, Matteo Montorfano, Juan Fernández-Armenta, James E Harvey, Josep Rodés-Cabau, Norbert Klein, Sajjad A Sabir, Jung-Sun Kim, Stephane Cook, Ran Kornowski, Antti Saraste, Jens E Nielsen-Kudsk, Dhiraj Gupta, Lucas Boersma, Lorenz Räber, Kolja Sievert, Horst Sievert, Stefan Bertog
BACKGROUND: Left atrial appendage (LAA) occluder embolization is an infrequent but serious complication. OBJECTIVES: We aim to describe timing, management and clinical outcomes of device embolization in a multi-center registry. METHODS: Patient characteristics, imaging findings and procedure and follow-up data were collected retrospectively. Device embolizations were categorized according to 1) timing 2) management and 3) clinical outcomes...
February 28, 2024: Cardiovascular Revascularization Medicine: Including Molecular Interventions
#13
Elena Basabe, José C De La Flor, Virginia López de la Manzanara, Luis Nombela-Franco, Carlos Narváez-Mejía, Leónidas Cruzado, Daniel Villa, Rocío Zamora, Manuel Tapia, Miguel Ángel Sastre, Edurne López Soberón, José A Herrero Calvo, Alfonso Suárez, David Martí Sánchez
Non-valvular atrial fibrillation (NVAF) is the most common cardiac arrhythmia in the general population, and its prevalence increases among patients with chronic kidney disease (CKD) undergoing hemodialysis. This population presents high risk of both hemorrhagic and thrombotic events, with little evidence regarding the use of oral anticoagulation treatment (OAT) and multiple complications arising from it; however, stroke prevention with percutaneous left atrial appendage closure (LAAC) is an alternative to be considered...
January 29, 2024: Medicina
#14
JOURNAL ARTICLE
Prasanti A Kotta, Vijay Nambi, Arunima Misra, Hamid Afshar, Mihail G Chelu, Khurram Nasir, Dmitry Abramov, Abdul Mannan Khan
BACKGROUND: The impact of socioeconomic status (SES) on the clinical outcomes of patients admitted to the hospital for atrial fibrillation (AF) is not well described. OBJECTIVE: We aim to study the association between median neighborhood household income (mNHI) and clinical outcomes among patients admitted to the hospital for AF. METHODS: We retrospectively analyzed primary AF hospitalizations from the United States National Inpatient Sample (NIS) between 2016 and 2020...
February 19, 2024: Heart Rhythm: the Official Journal of the Heart Rhythm Society
#15
Tatsuro Shoji, Yukio Sato, Daisuke Togashi, Shingo Kuwata, Masaki Izumo, Tomoo Harada, Yoshihiro J Akashi
A 70-year-old patient with paroxysmal atrial fibrillation underwent left atrial appendage closure. The patient experienced transient hypotension during device implantation. The procedure was abandoned because of ST-T-wave changes on electrocardiography and elevated coronary flow velocity on transesophageal echocardiography, which indicated that the device caused coronary artery compression.
February 21, 2024: JACC. Case reports
#16
JOURNAL ARTICLE
Farah Yasmin, Eman Ali, Abdul Moeed, Farwa Zaidi, Muhammad Umar, Vikash Virwani
INTRODUCTION: In patients with non-valvular atrial fibrillation (NVAF), mechanical occlusion of the left atrial appendage (LAA) using a permanently implanted device may be an effective alternative to oral anti-coagulants (OAC). To facilitate left atrial appendage closure (LAAC), multiple percutaneous devices have been proposed. Watchman Generation 2.5 and Amplatzer Amulet are the two most popular used devices for preventing stroke in patients with NVAF. We sought to compare safety and efficacy outcomes between Watchman 2...
2024: PloS One
#17
Michele Tomaselli, Giuseppe Verolino, Paolo Sganzerla, Mara Gavazzoni
BACKGROUND: Incomplete surgical left atrial appendage (LAA) closure, in the form of incompletely surgically ligated LAA (ISLL), increases thrombo-embolic risk in patients with atrial fibrillation (AF). Although its management is not standardized, the percutaneous closure of ISLL could be an alternative in patients with contraindication for anticoagulants. We present the case of a percutaneous transcatheter LAA device implantation in a patient with AF and ISLL, complicated by severe anaemia...
February 2024: European Heart Journal. Case Reports
#18
Raef Fadel, Essaq Khan, Waddah Maskoun
BACKGROUND: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, and the most common cause of cardioembolic stroke. The left atrial appendage (LAA) is the main source of thrombus formation in patients with AF. Therapies include use of percutaneous LAA closure devices, or surgical LAA occlusion (LAAO). Despite these options, complete closure of the LAA is not always achieved, and residual communication between the LAA and atrium may result in increased thrombus formation...
February 2024: European Heart Journal. Case Reports
#19
JOURNAL ARTICLE
Mohamad Alkhouli, James V Freeman, Christopher R Ellis, Atman P Shah, Hemal Gada, Megan Coylewright, Monica Lo, Akash Makkar, Himanshu Agarwal, Dhanunjaya Lakkireddy
BACKGROUND: The Food and Drug Administration approved the Amulet occluder (Abbott) after demonstrating safety and effectiveness in the Amulet IDE (AMPLATZER Amulet LAA Occluder) trial. OBJECTIVES: The aim of the EMERGE Left Atrial Appendage study is to evaluate early postapproval outcomes of the Amulet occluder in the United States using data from the National Cardiovascular Data Registry Left Atrial Appendage Occlusion Registry. METHODS: Patients with a commercial Amulet occluder implant attempt between Food and Drug Administration approval (August 14, 2021) and December 31, 2022, were included...
January 19, 2024: JACC. Cardiovascular Interventions
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JOURNAL ARTICLE
Marian Burysz, Michalina Malec-Litwinowicz, Jakub Batko, Radoslaw Litwinowicz, Mariusz Kowalewski, Bogus Aw Kapelak, Krzysztof Bartus
INTRODUCTION: Over the past decade, left atrial appendage occlusion (LAAO) has emerged as an established alternative to oral anticoagulation for patients diagnosed with atrial fibrillation (AF). The LARIAT device stands as the sole available epicardial system for complete percutaneous left atrial appendage (LAA) closure. AIM: To present the extended outcomes (spanning over 9 years of observation) in patients with AF who underwent epicardial LAAO. The presented results constitute the longest observation in world literature...
December 2023: Polish Journal of Cardio-Thoracic Surgery
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