Left Atrial Appendage: Embryology, Anatomy, Physiology, Arrhythmia and Therapeutic Intervention.

JACC. Clinical Electrophysiology
Niyada NaksukSamuel J Asirvatham

Abstract

Known for the pathological connection to atrial fibrillation (AF), the left atrial appendage (LAA) is the most common source of thromboembolism in patients with AF and may be an arrhythmogenic source for the maintenance of AF. Potential interventions of the LAA for stroke prevention have recently been developed through better understanding its anatomy and physiology. Occlusion of the LAA is an alternative to the use of life-long anticoagulation in selected nonvalvular AF cases. The PROTECT-AF (The WATCHMAN LAA Closure Device for Embolic PROTECTion in Patients with Atrial Fibrillation) and PREVAIL (Randomized Trial of LAA Closure vs. Warfarin for Stroke/Thromboembolic Prevention in Patients with Non-valvular Atrial Fibrillation) randomized controlled trials demonstrated that LAA exclusion using the Watchman percutaneous device is not inferior to warfarin. However, the appendage is structurally complex and has considerable morphological variations among individuals, and it can be challenging to generalize the device for all patients. Continued technological developments including occlusion/ligation through epicardial, endocardial, or surgical approaches, as well as operator expertise regarding LAA anatomy, physiology, and pathoph...Continue Reading

References

Dec 1, 1972·The Journal of Physiology·C T KappagodaH M Snow
Aug 1, 1995·The Anatomical Record·G ErnstJ Slany
Feb 1, 1996·The Annals of Thoracic Surgery·J L Blackshear, J A Odell
Dec 10, 1999·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·M E GoldmanJ L Halperin
Sep 29, 2005·The American Journal of Cardiology·Mark K FriedbergNorman H Silverman
Dec 19, 2006·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Bernhard Meier
Jan 3, 2007·The Journal of Thoracic and Cardiovascular Surgery·Keiji KamoharaKiyotaka Fukamachi
Jan 3, 2009·Heart, Lung & Circulation·Ujjwal K ChowdhuryPoonam Malhotra
Nov 11, 2009·Circulation·David R Holmes, Robert S Schwartz
Jul 8, 2010·Circulation·Luigi Di BiaseAndrea Natale
Aug 24, 2010·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Douglas MahEdward P Walsh
Sep 9, 2010·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Jai-Wun ParkBoris Leithäuser
Mar 19, 2011·JACC. Cardiovascular Imaging·Siobhan M LockwoodPhilip M Mottram
Jul 19, 2011·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Mélèze HociniMichel Haïssaguerre
Sep 15, 2011·Journal of Cardiovascular Electrophysiology·Paul A Friedman, David R Holmes
Oct 15, 2011·European Journal of Echocardiography : the Journal of the Working Group on Echocardiography of the European Society of Cardiology·Colin D ChueRichard P Steeds
Mar 1, 2013·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Hisham M F Sherif
Sep 17, 2013·Journal of Interventional Cardiology·Xavier FreixaRèda Ibrahim
Oct 23, 2013·Nature Reviews. Cardiology·Cheuk-Man YuBernhard Meier
Feb 14, 2014·Circulation. Cardiovascular Imaging·Masayoshi YamamotoKazutaka Aonuma
Sep 3, 2014·Journal of Cardiovascular Electrophysiology·Christopher V Desimone, Samuel J Asirvatham
Aug 4, 2015·BioMed Research International·Damiano RegazzoliPatrizio Mazzone
Aug 11, 2015·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Frederick A MasoudiUNKNOWN Society for Cardiovascular Angiography and Interventions
Oct 29, 2015·Stroke; a Journal of Cerebral Circulation·Shadi YaghiHooman Kamel
Mar 27, 2016·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Florentino LupercioLuigi Di Biase
Apr 1, 2014·Interventional Cardiology Clinics·Arun KanmanthareddyDhanunjaya Lakkireddy

❮ Previous
Next ❯

Citations

Nov 16, 2018·Circulation Journal : Official Journal of the Japanese Circulation Society·Jun-Seop SongHui-Nam Pak
May 11, 2019·American Journal of Physiology. Heart and Circulatory Physiology·Jiqiu ChenRoger J Hajjar
Nov 22, 2019·Journal of Cardiovascular Electrophysiology·Songnan WenSamuel J Asirvatham
May 15, 2020·Cardiology in the Young·Sakshi SachdevaSitaraman Radhakrishnan
Jun 26, 2020·Journal of Cardiovascular Electrophysiology·Domenico G Della RoccaAndrea Natale
Apr 18, 2019·Korean Journal of Radiology : Official Journal of the Korean Radiological Society·Hee Gone LeeSung Ho Hwang
Oct 4, 2019·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·Nabeela KarimTom Wong
Nov 26, 2020·Korean Journal of Radiology : Official Journal of the Korean Radiological Society·Hyungjoon ChoSung Ho Hwang
Feb 19, 2020·Cardiac Electrophysiology Clinics·Payam Safavi-Naeini, Abdi Rasekh
Feb 15, 2021·Heart, Lung & Circulation·Katarzyna SłodowskaMateusz K Hołda
Dec 29, 2020·Seminars in Thrombosis and Hemostasis·Nina D AnfinogenovaWladimir Y Ussov
Feb 19, 2020·Cardiac Electrophysiology Clinics·Krishna AkellaDhanunjaya Lakkireddy
May 4, 2021·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Prabhakar RajiahPraveen Ranganath

❮ Previous
Next ❯

Related Concepts

Related Feeds

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.

Atrial Filbrillation

Atrial fibrillation refers to the abnormal heart rhythm characterized by rapid and irregular beating of the atria. Here is the latest research.