Combined catheter ablation for atrial fibrillation and Watchman® left atrial appendage occlusion procedures: Five-year experience
Background: Patients with atrial fibrillation (AF) may benefit from undergoing concomitant interventions of left atrial catheter ablation and device occlusion of the left atrial appendage (LAA) as a two-pronged strategy for rhythm control and stroke prevention. We report on the outcome of combined p...
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| Format: | Article |
| Language: | English |
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Wiley
2016-04-01
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| Series: | Journal of Arrhythmia |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1880427615001623 |
| _version_ | 1828285422843723776 |
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| author | Karen P. Phillips, MBBS Daniel T. Walker, B. Appl. Sci. Julie A. Humphries, MBBS |
| author_facet | Karen P. Phillips, MBBS Daniel T. Walker, B. Appl. Sci. Julie A. Humphries, MBBS |
| author_sort | Karen P. Phillips, MBBS |
| collection | DOAJ |
| description | Background: Patients with atrial fibrillation (AF) may benefit from undergoing concomitant interventions of left atrial catheter ablation and device occlusion of the left atrial appendage (LAA) as a two-pronged strategy for rhythm control and stroke prevention. We report on the outcome of combined procedures in a single center case series over a 5-year timeframe.
Methods: Ninety-eight patients with non-valvular AF and a mean CHA2DS2-VASc score 2.6±1.0 underwent either first time, or redo pulmonary vein isolation (PVI) procedures, followed by successful implant of a Watchman® device.
Results: All procedures were generally uncomplicated with a mean case time of 213±40 min. Complete LAA occlusion was achieved at initial implant in 92 (94%) patients. Satisfactory LAA occlusion was achieved in 100% of patients at 12 months, with a complete LAA occlusion rate of 86%. All patients discontinued oral anticoagulation. Persistent late peri-device leaks were more frequently associated with device angulation or shoulder protrusion, and were associated with a significantly lower achieved device compression of 12±3% vs. 15±5% (p<0.01) than complete occlusion. One ischemic stroke was recorded over a mean follow-up time of 802±439 days. Twelve months׳ freedom from detectable AF was achieved in 77% of patients.
Conclusions: Combined procedures of catheter ablation for AF and Watchman® LAA implant appear to be feasible and safe, with excellent rates of LAA occlusion achieved and an observed stroke rate of 0.5% per year during mid-term follow-up. Incomplete occlusion was associated with lower achieved device compression and was more frequently associated with suboptimal device position. |
| first_indexed | 2024-04-13T09:15:02Z |
| format | Article |
| id | doaj.art-f49da99eff2d4848bc3c07909178e228 |
| institution | Directory Open Access Journal |
| issn | 1880-4276 |
| language | English |
| last_indexed | 2024-04-13T09:15:02Z |
| publishDate | 2016-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Arrhythmia |
| spelling | doaj.art-f49da99eff2d4848bc3c07909178e2282022-12-22T02:52:45ZengWileyJournal of Arrhythmia1880-42762016-04-0132211912610.1016/j.joa.2015.11.001Combined catheter ablation for atrial fibrillation and Watchman® left atrial appendage occlusion procedures: Five-year experienceKaren P. Phillips, MBBSDaniel T. Walker, B. Appl. Sci.Julie A. Humphries, MBBSBackground: Patients with atrial fibrillation (AF) may benefit from undergoing concomitant interventions of left atrial catheter ablation and device occlusion of the left atrial appendage (LAA) as a two-pronged strategy for rhythm control and stroke prevention. We report on the outcome of combined procedures in a single center case series over a 5-year timeframe. Methods: Ninety-eight patients with non-valvular AF and a mean CHA2DS2-VASc score 2.6±1.0 underwent either first time, or redo pulmonary vein isolation (PVI) procedures, followed by successful implant of a Watchman® device. Results: All procedures were generally uncomplicated with a mean case time of 213±40 min. Complete LAA occlusion was achieved at initial implant in 92 (94%) patients. Satisfactory LAA occlusion was achieved in 100% of patients at 12 months, with a complete LAA occlusion rate of 86%. All patients discontinued oral anticoagulation. Persistent late peri-device leaks were more frequently associated with device angulation or shoulder protrusion, and were associated with a significantly lower achieved device compression of 12±3% vs. 15±5% (p<0.01) than complete occlusion. One ischemic stroke was recorded over a mean follow-up time of 802±439 days. Twelve months׳ freedom from detectable AF was achieved in 77% of patients. Conclusions: Combined procedures of catheter ablation for AF and Watchman® LAA implant appear to be feasible and safe, with excellent rates of LAA occlusion achieved and an observed stroke rate of 0.5% per year during mid-term follow-up. Incomplete occlusion was associated with lower achieved device compression and was more frequently associated with suboptimal device position.http://www.sciencedirect.com/science/article/pii/S1880427615001623Left atrial appendageDevice occlusionCatheter ablationAtrial fibrillationWatchman |
| spellingShingle | Karen P. Phillips, MBBS Daniel T. Walker, B. Appl. Sci. Julie A. Humphries, MBBS Combined catheter ablation for atrial fibrillation and Watchman® left atrial appendage occlusion procedures: Five-year experience Journal of Arrhythmia Left atrial appendage Device occlusion Catheter ablation Atrial fibrillation Watchman |
| title | Combined catheter ablation for atrial fibrillation and Watchman® left atrial appendage occlusion procedures: Five-year experience |
| title_full | Combined catheter ablation for atrial fibrillation and Watchman® left atrial appendage occlusion procedures: Five-year experience |
| title_fullStr | Combined catheter ablation for atrial fibrillation and Watchman® left atrial appendage occlusion procedures: Five-year experience |
| title_full_unstemmed | Combined catheter ablation for atrial fibrillation and Watchman® left atrial appendage occlusion procedures: Five-year experience |
| title_short | Combined catheter ablation for atrial fibrillation and Watchman® left atrial appendage occlusion procedures: Five-year experience |
| title_sort | combined catheter ablation for atrial fibrillation and watchman r left atrial appendage occlusion procedures five year experience |
| topic | Left atrial appendage Device occlusion Catheter ablation Atrial fibrillation Watchman |
| url | http://www.sciencedirect.com/science/article/pii/S1880427615001623 |
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