Journal article
Concomitant cryoballoon ablation and percutaneous closure of left atrial appendage in patients with atrial fibrillation
Europace (London, England), Vol.18(11), pp.1705-1710
11/2016
DOI: 10.1093/europace/euw007
PMID: 27402623
Abstract
Pulmonary veins (PVs) isolation is the cornerstone of atrial fibrillation (AF) ablation and can be achieved either by conventional radiofrequency ablation or by cryoenergy. Left atrial appendage (LAA) closure has been proposed as alternative treatment to vitamin K antagonists (VKA). We aimed to evaluate the feasibility of combining cryoballoon (CB) ablation and LAA occlusion in patients with AF and a high thromboembolic risk or contraindication to antithrombotic therapy.
Thirty-five patients (28 males, 74 ± 2 years) underwent CB ablation. Left atrial appendage occlusion was carried out by using two occluder devices (Amplatz Cardiac Plug, ACP, St. Jude Medical, MN, USA, in 25 patients; Watchman, Boston Scientific, MA, USA, in 10 patients). Thirty patients (86%) had previous stroke/TIA episodes, 6 patients (17%) had major bleeding while on VKA therapy, and 7 patients (20%) had inherited bleeding disorders. Over the follow-up (24 ± 12 months), atrial arrhythmias recurred in 10 (28%) patients. Thirty patients (86%) had complete sealing; 5 patients (14%) showed a residual flow (<5 mm) at first transoesophageal echocardiography (TEE) check, while at 1-year TEE residual flow was detected in 3 patients. In 13 patients (37%), VKA therapy was immediately discontinued. Six patients (17%) received novel oral anticoagulants treatment and then discontinued 3 months thereafter. No device-related complications or clinical thromboembolic events occurred.
Combined CB ablation and LAA closure using different devices appears to be feasible in patients with non-valvular AF associated with high risk of stroke or contraindication to antithrombotic treatment.
Details
- Title: Subtitle
- Concomitant cryoballoon ablation and percutaneous closure of left atrial appendage in patients with atrial fibrillation
- Creators
- Gaetano Fassini - University of MilanSergio Conti - University of MilanMassimo Moltrasio - University of MilanAnna Maltagliati - Centro Cardiologico MonzinoFabrizio Tundo - University of MilanStefania Riva - University of MilanAntonio Dello Russo - University of MilanMichela Casella - University of MilanBenedetta Majocchi - University of MilanMartina Zucchetti - University of MilanEleonora Russo - University of MilanVittoria Marino - University of MilanMauro Pepi - Centro Cardiologico MonzinoClaudio Tondo - University of Milan
- Resource Type
- Journal article
- Publication Details
- Europace (London, England), Vol.18(11), pp.1705-1710
- DOI
- 10.1093/europace/euw007
- PMID
- 27402623
- ISSN
- 1099-5129
- eISSN
- 1532-2092
- Language
- English
- Date published
- 11/2016
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984822988002771
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