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Impact of Left Atrial Appendage Closure on LAA Thrombus Formation and Thromboembolism After LAA Isolation

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Impact of Left Atrial Appendage Closure on LAA Thrombus Formation and Thromboembolism After LAA Isolation. / Fink, Thomas; Vogler, Julia; Heeger, Christian-Hendrik; Sano, Makoto; Sciacca, Vanessa; Reissmann, Bruno; Wohlmuth, Peter; Keelani, Ahmad; Schütte, Christopher; Eitel, Charlotte; Eitel, Ingo; Maurer, Tilman; Rottner, Laura; Rillig, Andreas; Mathew, Shibu; Metzner, Andreas; Ouyang, Feifan; Kuck, Karl-Heinz; Tilz, Roland Richard.

In: JACC-CLIN ELECTROPHY, Vol. 6, No. 13, 14.12.2020, p. 1687-1697.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Fink, T, Vogler, J, Heeger, C-H, Sano, M, Sciacca, V, Reissmann, B, Wohlmuth, P, Keelani, A, Schütte, C, Eitel, C, Eitel, I, Maurer, T, Rottner, L, Rillig, A, Mathew, S, Metzner, A, Ouyang, F, Kuck, K-H & Tilz, RR 2020, 'Impact of Left Atrial Appendage Closure on LAA Thrombus Formation and Thromboembolism After LAA Isolation', JACC-CLIN ELECTROPHY, vol. 6, no. 13, pp. 1687-1697. https://doi.org/10.1016/j.jacep.2020.07.003

APA

Fink, T., Vogler, J., Heeger, C-H., Sano, M., Sciacca, V., Reissmann, B., Wohlmuth, P., Keelani, A., Schütte, C., Eitel, C., Eitel, I., Maurer, T., Rottner, L., Rillig, A., Mathew, S., Metzner, A., Ouyang, F., Kuck, K-H., & Tilz, R. R. (2020). Impact of Left Atrial Appendage Closure on LAA Thrombus Formation and Thromboembolism After LAA Isolation. JACC-CLIN ELECTROPHY, 6(13), 1687-1697. https://doi.org/10.1016/j.jacep.2020.07.003

Vancouver

Fink T, Vogler J, Heeger C-H, Sano M, Sciacca V, Reissmann B et al. Impact of Left Atrial Appendage Closure on LAA Thrombus Formation and Thromboembolism After LAA Isolation. JACC-CLIN ELECTROPHY. 2020 Dec 14;6(13):1687-1697. https://doi.org/10.1016/j.jacep.2020.07.003

Bibtex

@article{3f823b1363bd47c9b8e987fcf5d38e12,
title = "Impact of Left Atrial Appendage Closure on LAA Thrombus Formation and Thromboembolism After LAA Isolation",
abstract = "OBJECTIVES: This study sought to evaluate the safety and effectiveness of electrical isolation of the left atrial appendage (LAAEI) as well as the status of left atrial appendage closure (LAAC) in these patients.BACKGROUND: Catheter-based LAAEI is increasingly performed for treatment of symptomatic atrial fibrillation and pulmonary vein isolation nonresponders. Previous studies indicate an increased incidence of thromboembolic events after LAAEI despite effective oral anticoagulation. Interventional LAAC may prevent cardioembolic events after LAAEI but data regarding safety, feasibility, and efficacy of LAAC in this clinical setting are scarce.METHODS: Consecutive patients who underwent LAAEI at 2 German tertiary care hospitals were analyzed.RESULTS: A total of 270 patients underwent LAAEI by radiofrequency ablation in 255 (94.4%), cryoballoon ablation in 12 (4.4%), and by a combination of both techniques in 3 cases (1.1%). Stroke or transient ischemic attack occurred in 24 of 244 (9.8%) individuals with available follow-up. LAA thrombus formation was found in 53 patients (19.6%). A total of 150 patients underwent LAAC after LAAEI. No LAA thrombus was documented in any patient who underwent LAAC. Of the patients who underwent LAAEI, 67.6% were in sinus rhythm after a mean of 682.7 ± 61.7 days. LAA flow after LAAEI but not arrhythmia recurrence was identified as an independent predictor of stroke and/or transient ischemic attack or LAA thrombus (p < 0.0001).CONCLUSIONS: Sinus rhythm was documented in about two-third of patients undergoing LAAEI as treatment of therapy refractory atrial arrhythmias. LAAC potentially prevents LAA thrombus formation and thromboembolism.",
keywords = "Atrial Appendage/diagnostic imaging, Atrial Fibrillation/epidemiology, Catheter Ablation/adverse effects, Humans, Thromboembolism/epidemiology, Thrombosis/epidemiology",
author = "Thomas Fink and Julia Vogler and Christian-Hendrik Heeger and Makoto Sano and Vanessa Sciacca and Bruno Reissmann and Peter Wohlmuth and Ahmad Keelani and Christopher Sch{\"u}tte and Charlotte Eitel and Ingo Eitel and Tilman Maurer and Laura Rottner and Andreas Rillig and Shibu Mathew and Andreas Metzner and Feifan Ouyang and Karl-Heinz Kuck and Tilz, {Roland Richard}",
note = "Copyright {\textcopyright} 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.",
year = "2020",
month = dec,
day = "14",
doi = "10.1016/j.jacep.2020.07.003",
language = "English",
volume = "6",
pages = "1687--1697",
journal = "JACC-CLIN ELECTROPHY",
issn = "2405-500X",
publisher = "Elsevier USA",
number = "13",

}

RIS

TY - JOUR

T1 - Impact of Left Atrial Appendage Closure on LAA Thrombus Formation and Thromboembolism After LAA Isolation

AU - Fink, Thomas

AU - Vogler, Julia

AU - Heeger, Christian-Hendrik

AU - Sano, Makoto

AU - Sciacca, Vanessa

AU - Reissmann, Bruno

AU - Wohlmuth, Peter

AU - Keelani, Ahmad

AU - Schütte, Christopher

AU - Eitel, Charlotte

AU - Eitel, Ingo

AU - Maurer, Tilman

AU - Rottner, Laura

AU - Rillig, Andreas

AU - Mathew, Shibu

AU - Metzner, Andreas

AU - Ouyang, Feifan

AU - Kuck, Karl-Heinz

AU - Tilz, Roland Richard

N1 - Copyright © 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

PY - 2020/12/14

Y1 - 2020/12/14

N2 - OBJECTIVES: This study sought to evaluate the safety and effectiveness of electrical isolation of the left atrial appendage (LAAEI) as well as the status of left atrial appendage closure (LAAC) in these patients.BACKGROUND: Catheter-based LAAEI is increasingly performed for treatment of symptomatic atrial fibrillation and pulmonary vein isolation nonresponders. Previous studies indicate an increased incidence of thromboembolic events after LAAEI despite effective oral anticoagulation. Interventional LAAC may prevent cardioembolic events after LAAEI but data regarding safety, feasibility, and efficacy of LAAC in this clinical setting are scarce.METHODS: Consecutive patients who underwent LAAEI at 2 German tertiary care hospitals were analyzed.RESULTS: A total of 270 patients underwent LAAEI by radiofrequency ablation in 255 (94.4%), cryoballoon ablation in 12 (4.4%), and by a combination of both techniques in 3 cases (1.1%). Stroke or transient ischemic attack occurred in 24 of 244 (9.8%) individuals with available follow-up. LAA thrombus formation was found in 53 patients (19.6%). A total of 150 patients underwent LAAC after LAAEI. No LAA thrombus was documented in any patient who underwent LAAC. Of the patients who underwent LAAEI, 67.6% were in sinus rhythm after a mean of 682.7 ± 61.7 days. LAA flow after LAAEI but not arrhythmia recurrence was identified as an independent predictor of stroke and/or transient ischemic attack or LAA thrombus (p < 0.0001).CONCLUSIONS: Sinus rhythm was documented in about two-third of patients undergoing LAAEI as treatment of therapy refractory atrial arrhythmias. LAAC potentially prevents LAA thrombus formation and thromboembolism.

AB - OBJECTIVES: This study sought to evaluate the safety and effectiveness of electrical isolation of the left atrial appendage (LAAEI) as well as the status of left atrial appendage closure (LAAC) in these patients.BACKGROUND: Catheter-based LAAEI is increasingly performed for treatment of symptomatic atrial fibrillation and pulmonary vein isolation nonresponders. Previous studies indicate an increased incidence of thromboembolic events after LAAEI despite effective oral anticoagulation. Interventional LAAC may prevent cardioembolic events after LAAEI but data regarding safety, feasibility, and efficacy of LAAC in this clinical setting are scarce.METHODS: Consecutive patients who underwent LAAEI at 2 German tertiary care hospitals were analyzed.RESULTS: A total of 270 patients underwent LAAEI by radiofrequency ablation in 255 (94.4%), cryoballoon ablation in 12 (4.4%), and by a combination of both techniques in 3 cases (1.1%). Stroke or transient ischemic attack occurred in 24 of 244 (9.8%) individuals with available follow-up. LAA thrombus formation was found in 53 patients (19.6%). A total of 150 patients underwent LAAC after LAAEI. No LAA thrombus was documented in any patient who underwent LAAC. Of the patients who underwent LAAEI, 67.6% were in sinus rhythm after a mean of 682.7 ± 61.7 days. LAA flow after LAAEI but not arrhythmia recurrence was identified as an independent predictor of stroke and/or transient ischemic attack or LAA thrombus (p < 0.0001).CONCLUSIONS: Sinus rhythm was documented in about two-third of patients undergoing LAAEI as treatment of therapy refractory atrial arrhythmias. LAAC potentially prevents LAA thrombus formation and thromboembolism.

KW - Atrial Appendage/diagnostic imaging

KW - Atrial Fibrillation/epidemiology

KW - Catheter Ablation/adverse effects

KW - Humans

KW - Thromboembolism/epidemiology

KW - Thrombosis/epidemiology

U2 - 10.1016/j.jacep.2020.07.003

DO - 10.1016/j.jacep.2020.07.003

M3 - SCORING: Journal article

C2 - 33334448

VL - 6

SP - 1687

EP - 1697

JO - JACC-CLIN ELECTROPHY

JF - JACC-CLIN ELECTROPHY

SN - 2405-500X

IS - 13

ER -