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Updated: Dec 4, 2025
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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
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Percutaneous epicardial approach for LAA ligation
José M Sanchez1, Adam Lee2, Krzysztof Bartus3
1Section of Cardiac Electrophysiology, Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Summary
Percutaneous epicardial LAA ligation successfully excluded the left atrial appendage in dogs. This novel approach shows promise for AF treatment without complications.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
- Medical Devices
Background:
- The left atrial appendage (LAA) is a primary source of thrombus formation and a key factor in atrial fibrillation (AF) initiation.
- LAA ligation is explored as an adjunctive therapy for AF management.
Purpose of the Study:
- To assess the feasibility of a percutaneous epicardial approach for LAA ligation.
- To evaluate a novel technique for LAA exclusion.
Main Methods:
- A percutaneous subxyphoid approach was used to access the pericardium in 5 dogs.
- Epicardial cannulation, LAA visualization, suction-cup catheter attachment, and snare device ligation were performed under fluoroscopic guidance.
- LAA closure was verified using LA angiography and ICE, followed by post-hoc gross examination.
Main Results:
- Successful epicardial suture ligation of the LAA was achieved in all 5 dogs.
- Complete LAA closure was confirmed by angiography and gross examination.
- Minor hematoma at the suction site was the only noted finding, with no LAA laceration or perforation.
Conclusions:
- A novel percutaneous epicardial-only approach for LAA exclusion is feasible and safe in an animal model.
- This technique offers a potential new strategy for managing AF by excluding the LAA.
