المؤلفون: Helal, Baraa, Khan, Jibran, AlJayar, Dalia, Khan, Mohammad Salman, Alabdaljabar, Mohamad S., Asad, Zain Ul Abideen, DeSimone, Christopher V., Deshmukh, Abhishek^{Aff4, IDs1084002301729z_cor8}

المصدر: Journal of Interventional Cardiac Electrophysiology: An International Journal of Cardiac Arrhythmias and Rhythm Management. 67(4):865-885

المؤلفون: Nirmalan, Jonatan Gerard, Kramer, Anders, Korsholm, Kasper, Jensen, Jesper Møller, Nielsen-Kudsk, Jens Erik^{Aff1, IDs1084002301665y_cor5}

المصدر: Journal of Interventional Cardiac Electrophysiology: An International Journal of Cardiac Arrhythmias and Rhythm Management. 67(4):785-795

المؤلفون: Jakub Maksym, Marcin Grabowski, Tomasz Mazurek

المصدر: Advances in Interventional Cardiology, Vol 20, Iss 1, Pp 18-29 (2024)

مصطلحات موضوعية: atrial fibrillation, left atrial appendage closure, device-related thrombus, peri-device leak, Medicine

الوصف: 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. Percutaneous left atrial appendage closure (LAAC) has become an important non-pharmacological intervention for stroke prevention in patients with non-valvular AF. The procedure aims to reduce the risk of thromboembolism without increasing the risk of bleeding. Over the last few years, the safety and long-term efficacy of the procedure in specific populations have increased and more patients are being treated. The Watchman device is the most studied device in this field. Randomized controlled trials demonstrated non-inferiority of percutaneous left atrial appendage closure using the WATCHMAN 2.5 device to OAC (Boston Scientific, Marlborough, MA, USA). The new generation device, WATCHMAN FLX, was introduced and its use was associated with fewer safety events and a higher success rate of effective appendage closure. Nevertheless, several unsolved problems remain, including device-related thrombosis, the post-LAAC antithrombotic regimen, and peri-device leakage. This review will focus on LAAC with the Watchman device for stroke prevention in AF patients. Current status, available literature, clinical safety and efficacy will be summarized.

وصف الملف: electronic resource

Relation: https://www.termedia.pl/Percutaneous-left-atrial-appendage-closure-with-the-r-nWatchman-device-a-systematic-review,35,52665,1,1.html; https://doaj.org/toc/1734-9338; https://doaj.org/toc/1897-4295

URL الوصول: https://doaj.org/article/3756324453f34134a1282b48680a8707

المؤلفون: Li, Shiqi, Dong, Jing, Luo, Jie, Wang, Gaofeng, Xie, Dujiang^{Aff1, IDs1055402202748z_cor5}, Zhou, Ling^{Aff1, IDs1055402202748z_cor6}

المصدر: The International Journal of Cardiovascular Imaging: X-Ray Imaging, Intravascular Imaging, Echocardiography, Nuclear Cardiology, Computed Tomography and Magnetic Resonance Imaging. 39(3):659-666

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المؤلفون: Yibo Ma, Lanyan Guo, Miaoyang Hu, Qun Yan, Haitao Liu, Fu Yi

المصدر: Frontiers in Cardiovascular Medicine, Vol 10 (2023)

مصطلحات موضوعية: atrial fibrillation, left atrial appendage occlusion, cryoballoon ablation, radiofrequency ablation, peri-device leak, Diseases of the circulatory (Cardiovascular) system, RC666-701

الوصف: BackgroundA one-stop procedure involving catheter ablation and left atrial appendage occlusion (LAAO) is an option for high-risk atrial fibrillation patients. Few studies have reported the efficacy and safety of cryoballoon ablation (CBA) combined with LAAO, and no studies have compared the combination of LAAO with CBA or radiofrequency ablation (RFA).MethodsA total of 112 patients were enrolled in the present study; 45 patients received CBA combined with LAAO (group 1), and 67 patients received RFA combined with LAAO (group 2). Patient follow-up was performed for 1 year to detect peri-device leaks (PDLs) and safety outcomes (defined as a composite of peri-procedural and follow-up adverse events).ResultsThe number of PDLs at the median 59 days follow-up was comparable between the two groups (33.3% in group 1 vs. 37.3% in group 2, p = 0.693). Safety outcomes were also comparable between the two groups (6.7% in group 1 vs. 7.5% in group 2, p = 1.000). Multivariable regression showed that PDLs risk and safety outcomes were all similar between the two groups. Subgroup analysis of PDLs indicated no significant differences. Follow-up safety outcomes were related to anticoagulant medication, and patients without PDLs were more likely to discontinue antithrombotic therapy. The total procedure and ablation times were all significantly shorter for group 1.ConclusionWhen compared with left atrial appendage occlusion combined with radiofrequency, left atrial appendage occlusion combined with cryoballoon ablation has the same risk of peri-device leaks and safety outcomes, but the procedure time was significantly reduced.

وصف الملف: electronic resource

Relation: https://www.frontiersin.org/articles/10.3389/fcvm.2023.1153158/full; https://doaj.org/toc/2297-055X

URL الوصول: https://doaj.org/article/303a2528628a4878a830a8615df6b9b4

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المؤلفون: Fry, Ethan^Aff1, Bollempali, Harini, Suarez, Keith, Banchs, Javier, Michel, Jeffrey

المصدر: Journal of Interventional Cardiac Electrophysiology: An International Journal of Cardiac Arrhythmias and Rhythm Management. 61(1):137-144

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المؤلفون: Yibo Ma, Miaoyang Hu, Lanyan Guo, Jian Xu, Jie Li, Qun Yan, Huani Pang, Jinshui Wang, Ping Yang, Fu Yi

المصدر: Journal of Clinical Medicine, Vol 12, Iss 5, p 1960 (2023)

مصطلحات موضوعية: atrial fibrillation, vein of Marshall, left atrial appendage occlusion, peri-device leak, cardiac computed tomography angiography, Medicine

الوصف: Background: Ethanol infusion in the vein of Marshall (EI-VOM) has the advantages of reducing the burden of atrial fibrillation (AF), decreasing AF recurrence, and facilitating left pulmonary vein isolation and mitral isthmus bidirectional conduction block. Moreover, it can lead to prominent edema of the coumadin ridge and atrial infarction. Whether these lesions will affect the efficacy and safety of left atrial appendage occlusion (LAAO) has not yet been reported. Objectives: To explore the clinical outcome of EI-VOM on LAAO during implantation and after 60 days of follow-up. Methods: A total of 100 consecutive patients who underwent radiofrequency catheter ablation combined with LAAO were enrolled in this study. Patients who also underwent EI-VOM at the same period of LAAO were assigned to group 1 (n = 26), and those who did not undergo EI-VOM were assigned to group 2 (n = 74). The feasibility outcomes included intra-procedural LAAO parameters and follow-up LAAO results involving device-related thrombus, a peri-device leak (PDL), and adequate occlusion (defined as a PDL ≤ 5 mm). Safety outcomes were defined as the composites of severe adverse events and cardiac function. Outpatient follow-up was performed 60 days post-procedure. Results: Intra-procedural LAAO parameters, including the rate of device reselection, rate of device redeployment, rate of intra-procedural PDLs, and total LAAO time, were comparable between groups. Furthermore, intra-procedural adequate occlusion was achieved in all patients. After a median of 68 days, 94 (94.0%) patients received their first radiographic examination. Device-related thrombus was not detected in the follow-up populations. The incidence of follow-up PDLs was similar between the two groups (28.0% vs. 33.3%, p = 0.803). The incidence of adequate occlusion was comparable between groups (96.0% vs. 98.6%, p = 0.463). In group 1, none of the patients experienced severe adverse events. Ethanol infusion significantly reduced the right atrial diameter. Conclusions: The present study showed that undergoing an EI-VOM procedure did not impact the operation or effectiveness of LAAO. Combining EI-VOM with LAAO was safe and effective.

وصف الملف: electronic resource

Relation: https://www.mdpi.com/2077-0383/12/5/1960; https://doaj.org/toc/2077-0383

URL الوصول: https://doaj.org/article/8d685c3d41874414a053fd9fd559a602