دورية أكاديمية
Association of transcatheter left atrial appendage occlusion with acute changes in left atrial pressure: An invasive hemodynamic study.
| العنوان: | Association of transcatheter left atrial appendage occlusion with acute changes in left atrial pressure: An invasive hemodynamic study. |
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| المؤلفون: | Alarouri HS; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota., Lo Russo GV; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota., Chavez Ponce A; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota., Akkawi AR; Department of Internal Medicine, University of Kansas Medical Center, Wichita, Kansas., Mahayni A; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota., Sularz A; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota., Killu AM; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota., Simard T; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota., Singh G; Department of Cardiovascular Medicine, Mayo Clinic Health System, Eau Claire, Wisconsin., Miranda WR; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota., Alkhouli M; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota. Electronic address: alkhouli.mohamad@mayo.edu. |
| المصدر: | Heart rhythm [Heart Rhythm] 2024 Jul; Vol. 21 (7), pp. 1024-1031. Date of Electronic Publication: 2024 Feb 15. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Country of Publication: United States NLM ID: 101200317 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1556-3871 (Electronic) Linking ISSN: 15475271 NLM ISO Abbreviation: Heart Rhythm Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: New York, NY : Elsevier, c2004- |
| مواضيع طبية MeSH: | Atrial Appendage*/physiopathology , Atrial Appendage*/surgery , Atrial Fibrillation*/physiopathology , Atrial Fibrillation*/surgery , Atrial Fibrillation*/therapy , Cardiac Catheterization*/methods , Atrial Pressure*/physiology , Hemodynamics*/physiology, Humans ; Female ; Male ; Aged ; Septal Occluder Device ; Retrospective Studies ; Atrial Function, Left/physiology ; Follow-Up Studies ; Echocardiography, Transesophageal |
| مستخلص: | Background: The hemodynamic effects of transcatheter left atrial appendage occlusion (LAAO) remain unclear. Objective: We sought to assess the effect of LAAO on invasive hemodynamics and their correlation with clinical outcomes. Methods: We recorded mean left atrial pressure (mLAP) before and after device deployment. We assessed the prevalence and predictors of mLAP increase after deployment, the association between significant mLAP increase after deployment and 45-day peridevice leak (PDL), and the association between mLAP increase and heart failure (HF) hospitalization. A significant mLAP increase was defined as one equal to or greater than the mean percentage increase in mLAP after deployment (≥28%). Results: We included 302 patients (36.4% female; mean age, 75.8 ± 9.5 years). After deployment, mLAP increased in 48% of patients, 38% of whom experienced significant mLAP increase. Independent predictors of mLAP increase were baseline mLAP ≤14 mm Hg, nonparoxysmal atrial fibrillation, and age per 5 years (odds ratios: 3.66 [95% CI, 2.21-6.05], 1.81 [95% CI, 1.08-3.02], and 0.85 [95% CI, 0.73-0.99], respectively). Significant mLAP increase was an independent predictor of 45-day PDL (odds ratio, 2.55; 95% CI, 1.04-6.26). There was no association between mLAP increase and HF hospitalization. Conclusion: After deployment, mLAP acutely rises in 48% of patients, although this is not associated with increased HF hospitalizations. PDL is more likely to develop at 45 days in patients with significant increase in mLAP after deployment, although most leaks were small (<5 mm). These findings suggest that mLAP increase after deployment is not associated with major safety concerns. Additional studies are warranted to explore the long-term hemodynamic effects of LAAO. Competing Interests: Disclosures Dr Alkhouli is on the advisory board for Boston Scientific, Abbott, and Philips. All other authors have nothing to disclose. (Copyright © 2024 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.) |
| فهرسة مساهمة: | Keywords: Atrial fibrillation; Heart failure; Left atrial appendage occlusion; Left atrial pressure; Peridevice leak |
| تواريخ الأحداث: | Date Created: 20240216 Date Completed: 20240703 Latest Revision: 20240703 |
| رمز التحديث: | 20240704 |
| DOI: | 10.1016/j.hrthm.2024.02.022 |
| PMID: | 38365125 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1556-3871 |
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| DOI: | 10.1016/j.hrthm.2024.02.022 |