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Left atrial appendage occlusion

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https://www.readbyqxmd.com/read/28921386/midterm-outcomes-of-two-staged-hybrid-ablation-of-persistent-and-long-standing-persistent-atrial-fibrillation-using-the-versapolar-epicardial-surgical-device-and-subsequent-catheter-ablation
#1
Petr Budera, Pavel Osmancik, Dalibor Herman, Jana Zdarska, David Talavera, Anna Mala, Radka Prochazkova, Zbynek Straka
PURPOSE: Hybrid ablation of atrial fibrillation (AF) is a promising treatment strategy for patients with non-paroxysmal AF, although, data regarding mid-term outcomes are limited. METHODS: Patients with persistent or long-standing persistent AF were enrolled. Initially, a thoracoscopic, right-sided, epicardial ablation was performed, with a goal of creating a box lesion on the posterior wall of the left atrium; a novel versapolar radiofrequency (RF) catheter was used...
September 18, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28905045/left-atrial-appendage-occlusion-in-a-patient-with-hereditary-hemorrhagic-telangiectasia-and-atrial-fibrillation-a-therapeutic-option-worth-considering
#2
Maksymilian Mielczarek, Rafał Gałąska, Piotr Drewla, Dorota Kulawiak-Gałąska, Dariusz Ciećwierz, Marcin Gruchała
No abstract text is available yet for this article.
2017: Arch Med Sci Atheroscler Dis
https://www.readbyqxmd.com/read/28866042/intracardiac-echocardiography-from%C3%A2-the%C3%A2-left-atrium-for-procedural-guidance-of-transcatheter-left-atrial-appendage%C3%A2-occlusion
#3
Kasper Korsholm, Jesper Møller Jensen, Jens Erik Nielsen-Kudsk
OBJECTIVES: The aim of this study was to compare the efficacy and safety of intracardiac echocardiography (ICE) from the left atrium (LA) with transesophageal echocardiography (TEE) for procedural guidance of transcatheter left atrial appendage occlusion (LAAO). BACKGROUND: TEE with general anesthesia is the current gold standard to guide LAAO. By the use of ICE from the LA, LAAO can be performed in local anesthesia and may potentially have advantages over TEE. METHODS: A single-center, cohort study of patients undergoing LAAO with the Amplatzer Cardiac Plug or Amulet (St...
August 24, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28862376/rationale-and-design-of-a-global-registry-to-evaluate-real-world-clinical-outcomes-in-patients-with-atrial-fibrillation-and-high-risk-of-stroke-treated-with-left-atrial-appendage-occlusion-using-the-amplatzer-amulet-device-perspective-of-available-ongoing-registries
#4
David Hildick-Smith, Hans-Christoph Diener, Boris Schmidt, Vincent Paul, Magnus Settergren, Emmanuel Teiger, John Camm, Claudio Tondo, Ulf Landmesser
OBJECTIVES: To describe the rationale and design of a global prospective registry on catheter-based left atrial appendage (LAA) occlusion using the second generation AMPLATZER Amulet LAA occlusion device and to provide a comprehensive perspective on available/ongoing registries for catheter-based LAA occlusion. BACKGROUND: Given the increasing clinical application of catheter-based LAA occlusion, there is an important need for prospective real-world clinical data regarding this cardiac intervention...
September 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28836342/single-trans-septal-access-technique-for-left-atrial-intracardiac-echocardiography-to-guide-left-atrial-appendage-closure
#5
Daniel Aguirre, Christian Pincetti, Luis Perez, Carlos Deck, Mario Alfaro, Maria Jesus Vergara, Gabriel Maluenda
OBJECTIVE: This registry aimed to describe the safety and feasibility of a single trans-septal (TS) access technique for left intracardiac echocardiography (ICE) guidance of left-atrial appendage (LAA) closure procedure. BACKGROUND: LAA closure is currently accepted as an alternative to oral anticoagulation (OAC) in patients with non-valvular atrial fibrillation (NVAF) who are at high-risk for bleeding. Currently, LAA closure procedure is typically performed under trans-esophageal echocardiogram (TEE) guidance...
August 24, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28831085/percutaneous-closure-of-left-atrial-appendage-affects-mid-term-release-of-mr-proanp
#6
Michael Behnes, Benjamin Sartorius, Annika Wenke, Siegfried Lang, Ursula Hoffmann, Christian Fastner, Martin Borggrefe, Thomas Roth, Jakob Triebel, Thomas Bertsch, Ibrahim Akin
The left atrial appendage (LAA) represents both a predisposing source of thrombus formation and of neuro-humoral haemostasis. This study aims to evaluate changes of biomarker expression before and after successful percutaneous closure of the LAA. Patients with atrial fibrillation and contraindication for oral anticoagulant therapy were enrolled. Blood samples were taken within 24 hours before (T1) and at least 6 months (mid-term) (T2) after successful implantation of LAA occlusion devices. Blood levels of high sensitivity troponin I and T (hsTnI, hsTnT), aminoterminal pro-brain natriuretic peptide (NT-proBNP) and mid-regional pro-atrial natriuretic peptide (MR-proANP) were evaluated at both time points...
August 22, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28820546/initial-results-of-combined-mitraclip%C3%A3-%C3%A2-implantation-and-left-atrial-appendage-occlusion
#7
Xavier Freixa, Rodrigo Estévez-Loureiro, Fernando Carrasco-Chinchilla, Dabit Arzamendi, Pilar Jiménez-Quevedo, Luis Nombela-Franco, Ignacio Cruz-González, Ignacio J Amat-Santos, Manel Sabaté
BACKGROUND: Atrial fibrillation is present in 30-50% of patients undergoing percutaneous mitral valve repair. The presence of a formal contraindication to oral anticoagulation is also very common in these patients. In this context, percutaneous left atrial appendage occlusion (LAAO) may be a valid alternative for these patients. The study aim was to assess the feasibility, safety, and technical considerations of the combination of percutaneous mitral valve repair using the MitraClip system and LAAO...
March 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28805031/-ice-or-not-to-ice-during-laao-what-are-the-benefits-and-disadvantages-of-ice-during-laao
#8
EDITORIAL
Wassim Shatila, Zvonimir Krajcer
For left atrial appendage occlusion (LAAO), intracardiac echocardiography (ICE) could be a safe alternative to transesophageal echocardiography (TEE). ICE obviates the need for general anesthesia and can be readily implemented in practice. Randomized controlled trials are needed to assess the noninferiority of ICE to TEE for LAAO.
August 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28799239/left-atrial-appendage-occlusion-2016-in-review
#9
Manuel de J Ramos Ramirez, Bonnie Young, Kishore Harjai, Vernon Mascarenhas, Pugazhendhi Vijayaraman
A significant body of data has emerged in the area of Percutaneous Left Atrial Appendage Occlusion (LAAO). In this article, we present an overview of the most notable publications along with a review of the most important publications on LAAO in 2016. We also present important historical data such as landmark clinical studies, review of most utilized occlusion devices, and important clinical studies that are underway.
August 10, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28797952/left-atrial-appendage-closure-using-amplatzer%C3%A2-devices-a-large-multicenter-italian-registry
#10
Sergio Berti, Gennaro Santoro, Elvis Brscic, Matteo Montorfano, Luigi Vignali, Paolo Danna, Claudio Tondo, Gianpiero D'Amico, Amerigo Stabile, Salvatore Saccà, Giuseppe Patti, Antonio Rapacciuolo, Arnaldo Poli, Paolo Golino, Paolo Magnavacchi, Alberto De Caterina, Francesco Meucci, Bruno Pezzulich, Marco Rezzaghi, Miroslava Stolcova, Giuseppe Tarantini
BACKGROUND: Left atrial appendage occlusion (LAAO) has been proven to be effective for stroke prophylaxis in patients with non-valvular atrial fibrillation (NVAF). We aim to assess the safety and efficacy of LAAO by AMPLATZER™ devices in a large, multicenter, single-nation cohort of NVAF patients at high-risk of stroke and bleeding. METHODS: From December 2008 to April 2015 613 NVAF patients (75.1±8.0years, 62.5% male) underwent LAAO in 15 Italian centers by AMPLATZER™ devices...
July 16, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28795688/interventional-and-surgical-occlusion-of-the-left-atrial-appendage
#11
REVIEW
Etem Caliskan, James L Cox, David R Holmes, Bernhard Meier, Dhanunjaya R Lakkireddy, Volkmar Falk, Sacha P Salzberg, Maximilian Y Emmert
With a steadily increasing prevalence, atrial fibrillation (AF) is the most common sustained cardiac arrhythmia worldwide and an independent risk factor for stroke caused by thromboembolic events. The left atrial appendage (LAA) is the primary source of thromboemboli in patients with nonvalvular AF who have a stroke. Novel strategies (such as mechanical and nonpharmacological intervention) targeting the LAA in patients with AF for stroke prevention have become a major focus during the past decade. Some devices for percutaneous LAA occlusion are supported by robust clinical data obtained from randomized trials or large registries, and are a valid alternative to pharmacological stroke prevention...
August 10, 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/28758758/-thoracoscopic-epicardial-ablation-of-atrial-fibrillation-using-the-cobra-fusion-system-as-the-first-part-of-hybrid-ablation
#12
P Budera, P Osmančík, D Talavera, R Fojt, A Kraupnerová, J Žďárská, T Vaněk, Z Straka
INTRODUCTION: Treatment of persistent and long-standing persistent atrial fibrillation is not successfully managed by methods of catheter ablation or pharmacotherapy. Hybrid ablation (i.e. combination of minimally invasive surgical ablation, followed by electrophysiological assessment and subsequent endocardial catheter ablation to complete the entire intended procedure) presents an ever more used and very promising treatment method. METHOD: Patients underwent thoracoscopic ablation of pulmonary veins and posterior wall of the left atrium (the box-lesion) with use of the COBRA Fusion catheter; thoracoscopic occlusion of the left atrial appendage using the AtriClip system was also done in later patients...
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/28751849/anmco-aiac-sici-gise-sic-sicch-consensus-document-percutaneous-occlusion-of-the-left-atrial-appendage-in-non-valvular-atrial-fibrillation-patients-indications-patient-selection-staff-skills-organisation-and-training
#13
Gavino Casu, Michele Massimo Gulizia, Giulio Molon, Patrizio Mazzone, Andrea Audo, Giancarlo Casolo, Emilio Di Lorenzo, Michele Portoghese, Christian Pristipino, Renato Pietro Ricci, Sakis Themistoclakis, Luigi Padeletti, Claudio Tondo, Sergio Berti, Jacopo Andrea Oreglia, Gino Gerosa, Marco Zanobini, Gian Paolo Ussia, Giuseppe Musumeci, Francesco Romeo, Roberto Di Bartolomeo
Atrial fibrillation (AF) is the most common arrhythmia and its prevalence is increasing due to the progressive aging of the population. About 20% of strokes are attributable to AF and AF patients are at five-fold increased risk of stroke. The mainstay of treatment of AF is the prevention of thromboembolic complications with oral anticoagulation therapy. Drug treatment for many years has been based on the use of vitamin K antagonists, but recently newer and safer molecules have been introduced (dabigatran etexilate, rivaroxaban, apixaban, and edoxaban)...
May 2017: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://www.readbyqxmd.com/read/28750152/left-atrial-appendage-occlusion-for-stroke-prevention-in-patients-with-atrial-fibrillation
#14
REVIEW
Rizma Jalees Bajwa, Lara Kovell, Jon R Resar, Armin Arbab-Zadeh, Kaushik Mandal, Hugh Calkins, Ronald D Berger
Atrial fibrillation (AF) is a commonly sustained atrial arrhythmia with associated morbidity and mortality. AF is associated with increased risk of thromboembolism and stroke, requiring use of anticoagulation. Anticoagulation decreases the risk of stroke but is associated with a higher risk of bleeding, necessitating discontinuation in some patients. The left atrial appendage is the likely source of thrombus in the majority of patients with AF. This has led to the development of left atrial appendage occlusion as a means to reduce stroke risk in patients who have a contraindication to long-term anticoagulation...
July 27, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28736561/recent-advances-in-stroke-prevention-in-patients-with-atrial-fibrillation-and-end-stage-renal-disease
#15
REVIEW
Federico Ronco, Patrizio Mazzone, Leila Hosseinian, Simonetta Genovesi
BACKGROUND: Chronic kidney disease (CKD) is associated with a high prevalence of atrial fibrillation (AF), but in this population the risk/benefit ratio of anticoagulant therapy with vitamin K antagonists (VKA) for thromboprophylaxis is uncertain. SUMMARY: In end-stage renal disease (ESRD) patients undergoing hemodialysis, VKA seem less effective in stroke prevention than in the general population, with an increased risk of major bleeding. Recently, novel oral anticoagulant agents (NOACs) have proven to be effective for stroke prevention in AF and have demonstrated an improved safety profile compared to VKA...
June 2017: Cardiorenal Medicine
https://www.readbyqxmd.com/read/28714617/-left-atrial-appendage-occlusion-for-atrial-fibrillation
#16
Marco Roberto, Amir-Ali Fassa, Edoardo De Benedetti
Embolic stroke is the most dangerous complication of atrial fibrillation (AF). Oral anticoagulation represents the treatment of choice for thromboembolic (TE) prophylaxis in patients with a CHADS2VASc score ≥ 1 but is associated with a significant increase in haemorrhagic events. Almost 90 % of thrombi originate in the left atrial appendage. Registries have shown that percutaneous occlusion of this appendage reduces embolic risk and may be considered for TE prophylaxis in patients with a high TE (CHADS2VASc score ≥ 2) and haemorrhagic (HAS-BLED score ≥ 3) risk...
March 1, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28691914/residual-leaks-following-percutaneous-left-atrial-appendage-occlusion-assessment-and-management-implications
#17
Claire E Raphael, Paul A Friedman, Jacqueline Saw, Sorin V Pislaru, Thomas M Munger, David R Holmes
Left atrial appendage (LAA) closure for stroke prevention in the setting of non valvular atrial fibrillation is an alternative to oral anticoagulation in patients with increased bleeding risk. It allows similar reduction in thromboembolic events, in particular stroke, compared to warfarin. A common clinical dilemma is the management of patients with peri-device leak after LAA occlusion. This has been documented in both percutaneous as well as with surgical approaches. The specific definitions of leak severity, and the longer term clinical implications are poorly understood...
July 11, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28690086/combined-mitraclip-implantation-and-left-atrial-appendage-occlusion-because-it-s-there-revisited
#18
EDITORIAL
Duarte Cacela
No abstract text is available yet for this article.
July 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28675629/long-term-follow-up-after-left-atrial-appendage-occlusion-with-comparison-of-transesophageal-echocardiography-vs-computed-tomography-to-guide-medical-therapy-and-data-about-post-closure-cardioversion
#19
Benjamin Berte, Christine Attenhofer Jost, Dominik Maurer, Anja Fäh-Gunz, Xavier Pillois, Barbara Naegeli, Monica Pfyffer, Gabor Sütsch, Christoph Scharf
AIMS: The use of left atrial appendage (LAA)-occluders in atrial fibrillation is increasing. There are few data on the comparison between transesophageal echocardiography (TEE) and computed tomography (MDCT) assessing peridevice-flow and outcome of electrical cardioversion (ECV) in these patients. METHODS AND RESULTS: Single-center prospective registry from 2009 to 2015 including all LAA-occluders to analyze success and complications during implantation and follow-up...
July 4, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28673783/combined-mitraclip-implantation-and-left-atrial-appendage-occlusion-using-the-watchman-device-a-case-series-from-a-referral-center
#20
Ana Rita G Francisco, Eduardo Infante de Oliveira, Miguel Nobre Menezes, Pedro Carrilho Ferreira, Pedro Canas da Silva, Ângelo Nobre, Fausto J Pinto
INTRODUCTION: Patients referred for percutaneous transcatheter mitral valve repair using the MitraClip(®) system frequently have atrial fibrillation, which imposes additional challenges due to the need for oral anticoagulation. Left atrial appendage occlusion is currently regarded as a non-inferior alternative to anticoagulation in patients with non-valvular atrial fibrillation and both high thromboembolic and bleeding risk. Considering that both MitraClip implantation and left atrial appendage occlusion are percutaneous techniques that require transseptal puncture, it is technically attractive to consider their concomitant use...
July 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
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