Abstract:
INTRODUCTION:Oral anticoagulation therapy reduces significantly the risk of thromboembolism in patients with atrial fibrillation. However, effective oral anticoagulation therapy is not feasible in all patients. The interventional occlusion of the left atrial appendage may reduce the risk of thromboembolism in the latter patients. The aim of this prospective study was to assess the feasibility, safety, and technical aspects of interventionally occluding the left atrial appendage. METHODS AND RESULTS:The left atrial appendage was interventionally occluded with the new PLAATO device in nine patients. Serial transthoracic and transesophageal echocardiographic studies and neurologic assessment were performed prior to and during the procedure, and <48 hours, 3 months, 6 months, and 1 year after the procedure. Contraindications to oral anticoagulation were bleeding complications in 6 of 9 cases, cerebral aneurysm in 1, and allergies to warfarin therapy in 2 of 9. Baseline echocardiographic studies demonstrated spontaneous echo contrast grade 3 +/- 1, peak emptying velocities of 0.26 +/- 0.12 m/sec, and excluded atrial thrombi in all cases. Interventional occlusion was feasible in all cases. One patient had a minor plexus paresis that resolved within 4 weeks after the procedure. Neurologic assessment during a mean follow-up of 5 +/- 4.4 months did not demonstrate any new neurologic complications. Serial echocardiographic assessment excluded the formation of thrombi on the implanted device and demonstrated its complete thrombosis after 6 months. One patient developed a minimal pericardial effusion 48 hours after the procedure that resolved within 3 months. CONCLUSION:Interventional occlusion of the left atrial appendage is feasible and safe in patients with atrial fibrillation and contraindications to oral anticoagulation therapy. Furthermore, no neurologic complications, development of atrial thrombi, or thrombus formation on the device were observed during follow-up. Future prospective studies are needed to clarify the long-term treatment effect of this new technique.
journal_name
J Cardiovasc Electrophysioljournal_title
Journal of cardiovascular electrophysiologyauthors
Omran H,Hardung D,Schmidt H,Hammerstingl C,Lüderitz Bdoi
10.1046/j.1540-8167.14.s9.11.xkeywords:
subject
Has Abstractpub_date
2003-09-01 00:00:00pages
S56-9issue
9 Suppleissn
1045-3873issn
1540-8167journal_volume
14pub_type
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journal_title:Journal of cardiovascular electrophysiology
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abstract::We report on the entrapment of an ablation catheter by chordae tendineae in the mitral valve during radiofrequency (RF) ablation of ventricular tachycardia. The entrapped tip had to be removed via open surgery. Great care must be taken when performing radiofrequency ablation around the mitral valve apparatus. ...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
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journal_title:Journal of cardiovascular electrophysiology
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更新日期:2020-08-01 00:00:00
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doi:10.1111/j.1540-8167.2000.tb00004.x
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pub_type: 杂志文章
doi:10.1111/jce.13704
更新日期:2018-11-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章
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更新日期:2004-01-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1997.tb01039.x
更新日期:1997-12-01 00:00:00
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doi:10.1046/j.1540-8167.2002.01240.x
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,随机对照试验
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.2005.40664.x
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1540-8167.2007.01016.x
更新日期:2008-01-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章
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更新日期:2003-12-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.12914
更新日期:2016-04-01 00:00:00
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更新日期:2001-04-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.2003.03049.x
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1994.tb01123.x
更新日期:1994-10-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章
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journal_title:Journal of cardiovascular electrophysiology
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doi:10.1111/j.1540-8167.1993.tb01208.x
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pub_type: 杂志文章
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更新日期:2016-09-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章
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journal_title:Journal of cardiovascular electrophysiology
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更新日期:2009-01-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,评审
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更新日期:1995-01-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1994.tb01162.x
更新日期:1994-03-01 00:00:00
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pub_type: 杂志文章
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更新日期:2020-12-31 00:00:00