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Left atrial appendage occlusion

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https://www.readbyqxmd.com/read/29250272/percutaneous-left-atrial-appendage-closure-is-there-a-role-in-valvular-atrial-fibrillation
#1
REVIEW
Chetan Huded, Amar Krishnaswamy, Samir Kapadia
Atrial fibrillation, a chronic and highly morbid cardiovascular condition which affects over 33 million people worldwide, can be broadly categorized as valvular vs non-valvular in etiology. However, definitions of valvular atrial fibrillation have varied widely in the literature, and there is no clear consensus definition to date. Historically, patients with atrial fibrillation in the setting of rheumatic mitral valve disease have constituted a particularly high risk group for cardioembolic stroke, and for this reason many contemporary trials of pharmaceutical and device therapies for atrial fibrillation have systematically excluded patients with valvular heart disease...
February 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29236953/applications-of-cardiac-computed-tomography-in-electrophysiology-intervention
#2
S Liddy, U Buckley, H K Kok, B Loo, B Glover, G R Dhillon, O Buckley
Cardiac electrophysiology is an evolving specialty that has seen rapid advances in recent years. Concurrently, there has been much progress in the field of cardiac imaging. Electrophysiologists are increasingly requesting cross-sectional imaging in advance of many procedures. Pulmonary vein isolation and left atrial appendage (LAA) occlusion are now an established treatment options for atrial fibrillation. In patients undergoing pulmonary vein isolation, applications of computed tomography (CT) include evaluating the left atrial and pulmonary venous anatomy, excluding LAA thrombus and assessing for pulmonary vein stenosis...
December 9, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/29228158/percutaneous-left-atrial-appendage-occlusion-in-atrial-fibrillation-patients-with-a-contraindication-to-oral-anticoagulation-a-focused-review
#3
Marin Nishimura, Shiv Sab, Ryan R Reeves, Jonathan C Hsu
Stroke is the most feared complication of atrial fibrillation (AF). Although oral anticoagulation with non-vitamin K antagonist and non-vitamin K antagonist oral anticoagulants (NOACs) have been established to significantly reduce risk of stroke, real-world use of these agents are often suboptimal due to concerns for adverse events including bleeding from both patients and clinicians. Particularly in patients with previous serious bleeding, oral anticoagulation may be contraindicated. Left atrial appendage occlusion (LAAO), mechanically targeting the source of most of the thrombi in AF, holds an immense potential as an alternative to OAC in management of stroke prophylaxis...
December 8, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29223726/computed-tomography-measurement-of-the-left-atrial-appendage-for-optimal-sizing-of-the-watchman-device
#4
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...
December 5, 2017: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/29181735/-oral-anticoagulation-and-platelet-inhibition-after-atrial-appendage-occlusion
#5
REVIEW
Martin W Bergmann, Carsten W Israel
In Europe left atrial appendage occluders (LAAO) are most frequently used in patients with contraindications for oral anticoagulation (OAC); therefore, the classical therapeutic OAC scheme from the PROTECT-AF trial (vitamin K antagonist plus acetylsalicylic acid) is usually changed to dual anti-platelet therapy (DAPT) after implantation of a Watchman® or Amulet® LAAO (St. Jude Medical/Abbott, Eschborn, Germany). For many years, patients with an LAAO received DAPT for 1-6 months. The current standard comprises DAPT for 3 months, followed by permanent acetylsalicylic acid monotherapy if the transesophageal echocardiogram excludes a thrombus at the site of the LAAO...
December 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29158017/left-atrial-appendage-occlusion-exclusion-procedural-image-guidance-with-transesophageal-echocardiography
#6
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/29150698/surgical-techniques-for-left-atrial-appendage-exclusion
#7
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/29131295/the-intracardiac-concentrations-of-the-n-terminal-pro-b-type-natriuretic-peptide-nt-probnp-and-the-determinants-of-its-secretion-in-patients-with-atrial-fibrillation
#8
Witold Streb, Katarzyna Mitręga, Magdalena Szymała, Aleksandra Woźniak, Tomasz Podolecki, Zbigniew Kalarus
BACKGROUND: N-terminal-pro Brain Natriuretic Peptide (NT-proBNP) is elevated not only in heart failure (HF) but also in atrial fibrillation (AF). The role and secretion pattern of NT-proBNP in AF is still undetermined. AIM: The study aimed to assess NT-proBNP concentrations in patients with and without preserved left ventricular ejection fraction (LV-EF) depending on the type of AF. It was also intended to define the main source of NT-proBNP production within the heart...
November 13, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/29126973/percutaneous-left-atrial-appendage-occlusion-multimodality-imaging-step-by-step
#9
Manuel Barreiro-Pérez, Ignacio Cruz-González, Pedro L Sánchez
No abstract text is available yet for this article.
November 7, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/29122931/outcome-of-left-atrial-appendage-occlusion-in-high-risk-patients
#10
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/29101545/-recent-and-upcoming-randomized-trials-for-left-atrial-appendage-occlusion-need-for-a-definite-assessment-of-the-situation
#11
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
#12
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/29080014/-available-transvenous-occluder-designs-and-implantation-techniques
#13
REVIEW
P Sick, T Lewalter
In this article, most of the present or available in the near future left atrial appendage (LAA) occlusion devices are discussed in terms of structure of the devices and principle technique for implantation. Thus, the Watchman™ device from Boston, the Amulet™ device from Abbot, the Lambre™ device from Lifetech, the Occlutech® device from Occlutech®, and the WaveCrest® device from Biosense Webster (former Coherex) are discussed. The systems differ in terms of the concept of occlusion. Several devices consist of only one part (Watchman™ and Occlutech®) that is implanted in the body, ending up in the orifice of the LAA...
October 27, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29071390/-current-indications-for-left-atrial-appendage-occlusion
#14
REVIEW
Clemens Jilek, Thorsten Lewalter
Among patients with atrial fibrillation, the bleeding risk is linked to the stroke risk. Left atrial appendage (LAA) occlusion may reduce bleeding risk in high-risk patients. On the basis of a literature analysis and the Consensus Document of European Heart Rhythm Association (EHRA), the indications for a LAA occluder are clarified and a clear decision strategy for daily clinical practice is presented.
October 25, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29056953/percutaneous-interventions-in-elderly-patients-with-atrial-fibrillation-left-atrial-ablation-and-left-atrial-appendage-occlusion
#15
EDITORIAL
Evgeny N Mikhaylov, Tamas Szili-Torok, Dmitry S Lebedev
No abstract text is available yet for this article.
September 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/29055758/left-atrial-appendage-occlusion-in-the-presence-of-thrombus-with-a-lambre-device
#16
Ignacio Cruz-Gonzalez, Monica Fuertes Barahona, Jose Carlos Moreno-Samos, Manuel Barreiro-Perez, Javier Rodríguez-Collado, David Gonzalez-Calle, Pedro L Sanchez
No abstract text is available yet for this article.
November 13, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29051131/left-atrial-appendage-occlusion-is-promising-not-concerning
#17
Kasper Korsholm, Jens Erik Nielsen-Kudsk
No abstract text is available yet for this article.
October 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/29051130/concerns-about-left-atrial-appendage-occlusion
#18
Claudia Stöllberger, Birke Schneider
No abstract text is available yet for this article.
October 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/29047250/simultaneous-closure-of-a-left-atrial-appendage-through-an-atrial-septal-defect-and-the-atrial-septal-defect
#19
Shinjeong Song, Oh Hyun Lee, Jung Sun Kim, In Jeong Cho, Chi Young Shim, Geu Ru Hong, Hui Nam Pak, Yangsoo Jang
Left atrial appendage (LAA) occlusion can be employed as an alternative treatment to oral anticoagulation in patients with atrial fibrillation to prevent embolic events. Atrial septal defect (ASD) may be related with right heart dysfunction and allow paradoxical embolism to occur. However, occlusion of both LAA through atrial access with ostium secundum ASD and ASD in the same setting is unusual. Therefore, we report a case in which a LAA and an ASD was sequentially occluded.
November 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/29016813/epicardial-left-atrial-appendage-atriclip-occlusion-reduces-the-incidence-of-stroke-in-patients-with-atrial-fibrillation-undergoing-cardiac-surgery
#20
Etem Caliskan, Ayhan Sahin, Murat Yilmaz, Burkhardt Seifert, Ricarda Hinzpeter, Hatem Alkadhi, James L Cox, Tomas Holubec, Diana Reser, Volkmar Falk, Jürg Grünenfelder, Michele Genoni, Francesco Maisano, Sacha P Salzberg, Maximilian Y Emmert
Aims: Left atrial appendage (LAA) occlusion has emerged as an interesting alternative to oral anticoagulation (OAC) for stroke prevention in patients with atrial fibrillation (AF). We report the safety, efficacy, and durability of concomitant device-enabled epicardial LAA occlusion during open-heart surgery. In addition to long-term follow-up, we evaluate the impact on stroke risk in this selected population. Methods and results: A total of 291 AtriClip devices were deployed epicardially in patients (mean CHA2DS2-VASc-Score: 3...
July 18, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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