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Updated: Aug 25, 2025

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Left atrial appendage occlusion in ventricular assist device patients to decrease thromboembolic events: A computer

Mojgan Ghodrati-Misek1, Thomas Schlöglhofer1,2,3, Christoph Gross2,3

  • 1Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria.

Frontiers in Physiology
|October 17, 2022
PubMed
Summary
This summary is machine-generated.

Left atrial appendage occlusion (LAAO) in patients with left ventricular assist devices (LVADs) significantly reduces blood stagnation in the left atrial appendage, especially during atrial fibrillation (AF). This improves thrombosis-related parameters, potentially lowering stroke risk.

Keywords:
atrial fibrillationcomputational fluid dynamicsleft atrial appendage occlusionsinus rhythmthromboembolic riskventricular assist device

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Area of Science:

  • Cardiovascular Medicine
  • Biomedical Engineering
  • Computational Fluid Dynamics

Background:

  • Atrial fibrillation (AF) is a frequent comorbidity in left ventricular assist device (LVAD) patients, increasing thromboembolic stroke risk.
  • The left atrial appendage (LAA) is a suspected source of thrombosis due to blood stagnation.
  • Left atrial appendage occlusion (LAAO) has shown promise in reducing thromboembolic events.

Purpose of the Study:

  • To investigate the impact of LAAO on thrombosis-related parameters using patient-specific simulations in an LVAD patient.
  • To evaluate the effects of AF and LAAO on blood flow dynamics and stagnation within the left atrium and LAA.

Main Methods:

  • Patient-specific left ventricular and atrial geometries were obtained from CT scans.
  • Hemodynamic data were integrated with a lumped parameter model for sinus rhythm (SR) and AF.
  • Simulations assessed stagnation volume and blood residence time with and without LAAO under SR and AF conditions.

Main Results:

  • Atrial fibrillation significantly reduced atrial velocity and increased atrial stagnation volume by 55% compared to SR.
  • Blood residence time in the LAA exceeded 8 cardiac cycles during AF.
  • LAAO reduced atrial stagnation volume by approximately 66% in SR and 65% in AF simulations.
  • Significant stagnation volumes were observed in the LAA in both SR and AF, with higher values in AF.

Conclusions:

  • LAAO effectively diminishes blood stagnation in the LAA for LVAD patients, irrespective of rhythm (SR or AF).
  • Reduced stagnation and improved flow parameters post-LAAO suggest a decreased risk of thrombus formation and thromboembolic events originating from the LAA.
  • Patient-specific simulations provide valuable insights into the hemodynamic benefits of LAAO in this patient population.