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Related Experiment Video

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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Left Atrial Appendage Occlusion for Stroke Prevention.

Arijit Chanda1, John P Reilly1

  • 1John Ochsner Heart & Vascular Center, Cardiac Catheterization Laboratory, Ochsner Medical Center, 1514 Jefferson Hwy, New Orleans, LA 70121.

Progress in Cardiovascular Diseases
|May 2, 2017
PubMed
Summary

Atrial fibrillation (AF) patients at high stroke risk can opt for left atrial appendage (LAA) exclusion instead of anticoagulation. Several devices offer percutaneous LAA closure, minimizing stroke risk for those unsuitable for blood thinners.

Keywords:
AmuletAtrial fibrillationLariatLeft atrial appendage occlusionStrokeWatchman

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Area of Science:

  • Cardiology
  • Medical Devices
  • Interventional Procedures

Background:

  • Over 2.3 million US adults have atrial fibrillation (AF), significantly increasing stroke risk.
  • The left atrial appendage (LAA) is the primary source of thrombus in AF patients.
  • Anticoagulation is standard for stroke prevention but contraindicated in some patients.

Purpose of the Study:

  • To review percutaneous left atrial appendage (LAA) exclusion as an alternative to anticoagulation for stroke risk reduction in AF patients.
  • To discuss available LAA exclusion devices and their applications.

Main Methods:

  • Review of current percutaneous left atrial appendage (LAA) exclusion devices available in the US.
  • Discussion of the WATCHMAN®, Amulet®, and LARIAT® systems.
  • Consideration of procedural complications and operator experience.

Main Results:

  • Percutaneous LAA exclusion is a viable alternative for AF patients with contraindications to anticoagulation.
  • The WATCHMAN® device is FDA-approved and widely studied for LAA exclusion.
  • The Amulet® device is under investigation in a trial comparing it to WATCHMAN®, and the LARIAT® is a hybrid system.

Conclusions:

  • Percutaneous LAA closure offers a stroke risk reduction strategy for specific AF patient populations.
  • Operator experience is crucial for minimizing procedural complications associated with LAA exclusion.
  • Continued research and device development aim to improve safety and efficacy.