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Updated: Dec 28, 2025
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Systematic review on left atrial appendage closure with the LAmbre device in patients with non-valvular atrial
Muhammad Ali1, Angelos G Rigopoulos1, Mammad Mammadov1
1Mid-German Heart Center, Department of Internal Medicine III (KIM-III), Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle, Ernst-Grube-Strasse 40, D-06120, Halle (Saale), Germany.
Insights
The LAmbre™ device shows high success in percutaneous left atrial appendage closure for non-valvular atrial fibrillation patients. While effective for complex anatomies, further trials are needed to compare it with existing left atrial appendage closure devices.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Devices
Background:
- Left atrial appendage closure (LAAC) is a key stroke-prevention strategy for non-valvular atrial fibrillation (NVAF) patients with high bleeding risk.
- The LAmbre™ device is a novel occluder for LAAC, necessitating a review of its clinical performance.
Purpose of the Study:
- To systematically review the safety and efficacy of the LAmbre™ device for LAAC in NVAF patients.
- To evaluate the LAmbre™ device's performance in various LAA anatomies and compare it to existing LAAC devices.
Main Methods:
- A systematic literature search was performed by three independent reviewers.
- Included studies reported safety and therapeutic success of LAmbre™ LAAC in NVAF patients (n > 5).
Main Results:
- The review included 10 publications with 403 NVAF patients, showing a 99.7% implantation success rate.
- Major complications occurred in 2.9% of patients, with low rates of mortality (0.3%) and stroke (0.3%).
- The LAmbre™ device demonstrated favorable properties for challenging LAA anatomies, with no device embolization reported.
Conclusions:
- The LAmbre™ device exhibits excellent implantation success and promising follow-up data for LAAC in NVAF patients.
- While effective for complex anatomies and preventing embolization, its impact on pericardial tamponade requires further investigation.
- Larger prospective trials are necessary to compare the LAmbre™ device against established LAAC devices.
Background:
Percutaneous closure (LAAC) of the left atrial appendage (LAA) is an efficacious preventive procedure for patients with non-valvular atrial fibrillation (NVAF) and considerable bleeding risk. We sought to systematically review the available LAAC data on the novel occluder device LAmbre™.
Methods:
For this systematic review, a search of the literature was conducted by 3 independent reviewers, reporting the safety and therapeutic success of LAAC in patients being treated with a LAmbre™. Publications reporting the safety and therapeutic success of LAAC using LAmbre™ in n > 5 patients were included.
Results:
The literature search retrieved n = 10 publications, encompassing n = 403 NVAF patients treated with a LAmbre™ LAAC, with relevant data regarding safety and therapeutic success of the procedure. The mean CHA2DS2-VASc Score was 4.0 + 0.9, and the mean HAS-BLED score was 3.4 + 0.5. The implantation success was 99.7%, with a mean procedure time of 45.4 ± 18.7 min, and a fluoroscopy time of 9.6 ± 5.9 min, and a contrast agent volume of 96.7 ± 0.7 ml. The anticoagulation regimen was switched to DAPT post procedure in the majority of the patients (96.8%). Partial and full recapture were done in 45.5% and in 25.6%, respectively. Major complications were reported in 2.9%, with 0.3% mortality, 1.7% pericardial tamponade, 0.3% stroke, and 0.6% major bleeding complications; no device embolization was observed. During follow up at 6 or 12 months, major adverse cardiovascular events were reported in 3.3%: Stroke or TIA in 1.7%, thrombus formation on the device in 0.7%, and residual flow > 5 mm in 1.0%. In some publications, the favorable implantion properties of the LAmbre™ for difficult anatomies such as shallow or multilobular LAA anatomies were described.
Conclusions:
This systematic review on the LAmbre™ LAA-occluder including n = 403 NVAF patients demonstrates an excellent implantion success rate, promising follow-up clinical data, and favorable properties for also challenging LAA anatomies,. While its design seems to be helpful in preventing device embolization, pericardial tamponade may not be substantially reduced by the LAmbre™ as compared with other established LAAC devices. Further larger prospective multicenter registries and randomized trials are needed to scrutinize the value of the LAmbre™ compared with established LAAC devices.
