Feasibility and clinical efficacy of left atrial ablation for the treatment of atrial tachyarrhythmias in patients with left atrial appendage closure devices

Heart Rhythm : the Official Journal of the Heart Rhythm Society
Christian-Hendrik HeegerRoland Tilz

Abstract

Left atrial appendage (LAA) closure devices have been introduced recently as an alternative for oral anticoagulation (OAC) in patients with nonvalvular atrial fibrillation (AF). Because of potential overlap of ablation target areas and the previously implanted LAA closure device, as well as potential complications such as mechanical damage to the device, left atrial (LA) ablation remains a subject of debate in these patients. We report on the feasibility and clinical efficacy of LA ablation after implantation of LAA closure devices. Eight patients (6 men; age 69 ± 8 years) with symptomatic paroxysmal AF (n = 5) or persistent AF (mean CHA2DS2-VASc score 3.6 ± 0.7, mean HAS-BLED score 3.6 ± 1.5) and previously implanted WATCHMAN (7 patients) or AMPLATZER Cardiac Plug (1 patient) LAA closure devices received radiofrequency-based LA ablation (4 via circumferential pulmonary vein isolation [CPVI], 4 via CPVI and additional LA linear lesions or complex fractionated atrial electrograms) after a mean of 201 days (range 41-756 days) after LAA closure. Successful LA ablation was achieved without device interference or periprocedural complications. After a mean of 503 days (range 113-1006 days), transesophageal echocardiography (TEE) was ...Continue Reading

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Citations

Mar 31, 2015·Heart Rhythm : the Official Journal of the Heart Rhythm Society·David J Callans
Nov 1, 2018·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Lisette I S WintgensLucas V A Boersma
Jan 4, 2020·Cardiology and Therapy·Laura RottnerAndreas Rillig
Jan 13, 2018·Expert Review of Cardiovascular Therapy·Jose M SanchezRandall J Lee
Sep 1, 2020·The American Journal of Cardiology·Henry D HuangRichard G Trohman

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