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Updated: Sep 3, 2025
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Occluding morphologically complicated left atrial appendage using the small-umbrella LAmbre device
Hong-Da Zhang1, Ming Yang2, Yang-Bo Xing3
1Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, 167 Beilishi Road, Xicheng District, Beijing, 100037, China.
Insights
The small-umbrella LAmbre device effectively treats complex left atrial appendage (LAA) anatomy for stroke prevention in atrial fibrillation patients. This LAA occlusion offers a safe alternative when standard devices are unsuitable.
Area of Science:
- Cardiology
- Medical Devices
- Interventional Procedures
Background:
- Percutaneous left atrial appendage (LAA) occlusion is a key strategy for stroke prevention in atrial fibrillation.
- Complex LAA anatomies, including multiple lobes or large orifices, pose challenges for standard occlusion devices.
- The LAmbre device with a small-umbrella design was developed to address these anatomical complexities.
Purpose of the Study:
- To evaluate the feasibility, safety, and short-term efficacy of the small-umbrella LAmbre device for LAA occlusion.
- To assess the device's performance in patients with morphologically complicated LAA.
- To determine if the LAmbre device is a viable alternative for patients unsuitable for standard LAA occlusion devices.
Main Methods:
- Retrospective analysis of 129 patients undergoing LAA occlusion with the LAmbre device.
- Focus on 30 patients who received the small-umbrella LAmbre device.
- Analysis of patient characteristics, procedural details, and short-term outcomes, including transesophageal echocardiography at 3 months.
Main Results:
- The small-umbrella LAmbre device was used in 30 patients, 73.3% of whom had multilobed LAA.
- Successful anchoring of the occluder umbrella was achieved in various LAA structures.
- No peri-device residual flow was observed at 3-month follow-up in 24 patients.
- One patient experienced device thrombosis, which resolved with anticoagulation; one patient had an ischemic stroke; no other adverse events were reported.
Conclusions:
- The small-umbrella LAmbre device demonstrated feasibility, safety, and short-term effectiveness for occluding complex LAA anatomies.
- This device presents a valuable alternative for atrial fibrillation patients with challenging LAA morphology who cannot be treated with standard occlusion devices.
Background:
Percutaneous left atrial appendage (LAA) occlusion is effective for stroke prevention in patients with atrial fibrillation. LAA can have a complex anatomy, such as multiple lobes or a large orifice, which may render it unsuitable for occlusion using regular devices. We aimed to investigate the feasibility, safety, and short-term efficacy of the small-umbrella LAmbre device for morphologically complicated LAA.
Methods:
We retrospectively enrolled 129 consecutive patients who underwent LAA occlusion using the LAmbre device; the small-umbrella LAmbre device was used in 30 of these patients. We analyzed patients' characteristics, procedural details, and outcomes.
Results:
Twenty-two patients (73.3%) had multilobed (≥ 2) LAA. The umbrella of the occluder was anchored in the branch in 9 patients and in the common trunks of branches in 13 patients. The landing zone and orifice diameters were 19.0 ± 4.39 mm and 27.4 ± 3.95 mm, respectively. The sizes of the umbrella and occluder cover were 22.0 ± 3.42 mm and 34.3 ± 2.75 mm, respectively. At 3-month follow-up transesophageal echocardiography in 24 patients, no peri-device residual flow was reported. Device thrombosis was detected in one patient at 3 months and disappeared after 3 months of anticoagulation. Ischemic stroke occurred in one patient; no other adverse events were reported.
Conclusions:
Occlusion of morphologically complicated LAA using the small-umbrella LAmbre device was feasible, safe, and effective in patients with atrial fibrillation in this study. This occluder provides an alternative for patients who cannot be treated with regular-sized LAA occlusion devices.
