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Updated: May 17, 2026
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Percutaneous left atrial appendage suture ligation using the LARIAT device in patients with atrial fibrillation:
Krzysztof Bartus1, Frederick T Han2, Jacek Bednarek3
1Department of Cardiovascular Surgery and Transplantology, Jagiellonian University, John Paul II Hospital in Krakow, Krakow, Poland.
Insights
Percutaneous left atrial appendage (LAA) ligation using the LARIAT device effectively closed the LAA in 96% of patients, demonstrating a safe and viable option for reducing stroke risk in atrial fibrillation.
Area of Science:
- Cardiology
- Medical Devices
- Interventional Procedures
Background:
- Atrial fibrillation poses a significant risk of embolic stroke.
- Excluding the left atrial appendage (LAA) is a strategy to mitigate this risk.
Purpose of the Study:
- To evaluate the efficacy and safety of percutaneous LAA ligation using the LARIAT device.
Main Methods:
- Eighty-nine atrial fibrillation patients underwent LAA ligation with the catheter-based LARIAT device.
- Closure was assessed via transesophageal echocardiography (TEE) and contrast fluoroscopy at multiple time points up to 1 year.
Main Results:
- Successful LAA ligation was achieved in 96% of patients.
- Complete LAA closure was observed in 95% at 1 month and 98% at 1 year.
- Device-related complications were absent; 3 access-related complications and some adverse events were noted.
Conclusions:
- Percutaneous LAA closure with the LARIAT device is an effective procedure.
- The approach demonstrated acceptably low access complications and periprocedural adverse events in this observational study.
Objectives:
The purpose of the study was to determine the efficacy and safety of left atrial appendage (LAA) closure via a percutaneous LAA ligation approach.
Background:
Embolic stroke is the most devastating consequence of atrial fibrillation. Exclusion of the LAA is believed to decrease the risk of embolic stroke.
Methods:
Eighty-nine patients with atrial fibrillation were enrolled to undergo percutaneous ligation of the LAA with the LARIAT device. The catheter-based LARIAT device consists of a snare with a pre-tied suture that is guided epicardially over the LAA. LAA closure was confirmed with transesophageal echocardiography (TEE) and contrast fluoroscopy immediately, then with TEE at 1 day, 30 days, 90 days, and 1 year post-LAA ligation.
Results:
Eighty-five (96%) of 89 patients underwent successful LAA ligation. Eighty-one of 85 patients had complete closure immediately. Three of 85 patients had a ≤ 2-mm residual LAA leak by TEE color Doppler evaluation. One of 85 patients had a ≤ 3-mm jet by TEE. There were no complications due to the device. There were 3 access-related complications (during pericardial access, n = 2; and transseptal catheterization, n = 1). Adverse events included severe pericarditis post-operatively (n = 2), late pericardial effusion (n = 1), unexplained sudden death (n = 2), and late strokes thought to be non-embolic (n = 2). At 1 month (81 of 85) and 3 months (77 of 81) post-ligation, 95% of the patients had complete LAA closure by TEE. Of the patients undergoing 1-year TEE (n = 65), there was 98% complete LAA closure, including the patients with previous leaks.
Conclusions:
LAA closure with the LARIAT device can be performed effectively with acceptably low access complications and periprocedural adverse events in this observational study.
