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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Left atrial appendage studied by computed tomography to help planning for appendage closure device placement
Yan Wang1, Luigi Di Biase, Rodney P Horton
1Texas Cardiac Arrhythmia Institute at St. David's Medical Center, Austin, Texas, USA.
Journal of Cardiovascular Electrophysiology
|June 17, 2010
Summary
Cardiac CT reveals complex left atrial appendage (LAA) morphology, crucial for planning LAA closure device implantation. Perimeter-based diameter measurements are superior for accurate occluder sizing.
Area of Science:
- Cardiovascular Imaging
- Medical Device Technology
- Anatomical Studies
Background:
- Atrial fibrillation (AF) management often requires left atrial appendage (LAA) closure.
- Accurate preoperative planning is essential for successful LAA device implantation.
- Understanding LAA morphology is key to device selection.
Purpose of the Study:
- To quantitatively assess LAA morphologic parameters using computed tomography (CT).
- To aid in the preoperative planning and implantation of LAA closure devices.
Main Methods:
- A cardiac CT study was performed on 612 patients, with or without AF.
- LAA morphology, its relationship to the left superior pulmonary vein (LSPV), and LAA ostium shapes were classified.
- Various measurement methods for the LAA ostium were compared.
Main Results:
- LAA morphology was classified into ChickenWing, WindSock, Cauliflower, and Cactus types.
- LAA ostium shapes included oval, foot-like, triangular, water drop-like, and round.
- Perimeter-derived diameter was more accurate than direct measurement for LAA ostium sizing.
Conclusions:
- LAA and LA ostium morphology are highly complex and variable.
- Sixty-four-channel cardiac CT is valuable for preoperative planning of LAA closure.
- Perimeter-calculated LAA ostium diameter is the optimal parameter for LAA occluder sizing.
