OBJECTIVES: The exclusion of the left atrial appendage (LAA) has been used to reduce the risk of stroke associated with atrial fibrillation (AF). While LAA exclusion has been associated with a reduced risk of stroke, the effect on the electrical activity of the LAA (a potential source of AF) remains unknown. As such, we sought to demonstrate whether surgical epicardial clip occlusion leads to the electrical isolation of the LAA. METHODS: From December 2010 until August 2011, 10 patients with paroxysmal AF underwent off-pump coronary artery bypass surgery with bilateral pulmonary vein isolation and an LAA clip occlusion with a new epicardial clip. Before and after the clip was placed, pacing manoeuvres were performed to assess the electrical exit and entry blocks from the LAA. RESULTS: All clips were applied successfully. The mean procedure time for the clip application was 4 ± 1 min. No complications occurred related to clip application. Prior to the pericardial closure, 18 ± 3 min after the clip placement, the LAA stimulation and pacing manoeuvres demonstrated complete electrical isolation of the LAA in all cases. CONCLUSIONS: Epicardial LAA clip occlusion leads to the acute electrical isolation of the LAA and may not only provide stroke prevention but also reduce the recurrence of AF.
OBJECTIVES: The exclusion of the left atrial appendage (LAA) has been used to reduce the risk of stroke associated with atrial fibrillation (AF). While LAA exclusion has been associated with a reduced risk of stroke, the effect on the electrical activity of the LAA (a potential source of AF) remains unknown. As such, we sought to demonstrate whether surgical epicardial clip occlusion leads to the electrical isolation of the LAA. METHODS: From December 2010 until August 2011, 10 patients with paroxysmal AF underwent off-pump coronary artery bypass surgery with bilateral pulmonary vein isolation and an LAA clip occlusion with a new epicardial clip. Before and after the clip was placed, pacing manoeuvres were performed to assess the electrical exit and entry blocks from the LAA. RESULTS: All clips were applied successfully. The mean procedure time for the clip application was 4 ± 1 min. No complications occurred related to clip application. Prior to the pericardial closure, 18 ± 3 min after the clip placement, the LAA stimulation and pacing manoeuvres demonstrated complete electrical isolation of the LAA in all cases. CONCLUSIONS: Epicardial LAA clip occlusion leads to the acute electrical isolation of the LAA and may not only provide stroke prevention but also reduce the recurrence of AF.
Authors: Sébastien P J Krul; Antoine H G Driessen; Wim J van Boven; André C Linnenbank; Guillaume S C Geuzebroek; Warren M Jackman; Arthur A M Wilde; Jacques M T de Bakker; Joris R de Groot Journal: Circ Arrhythm Electrophysiol Date: 2011-04-14
Authors: Hugh Calkins; Josep Brugada; Douglas L Packer; Riccardo Cappato; Shih-Ann Chen; Harry J G Crijns; Ralph J Damiano; D Wyn Davies; David E Haines; Michel Haissaguerre; Yoshito Iesaka; Warren Jackman; Pierre Jais; Hans Kottkamp; Karl Heinz Kuck; Bruce D Lindsay; Francis E Marchlinski; Patrick M McCarthy; J Lluis Mont; Fred Morady; Koonlawee Nademanee; Andrea Natale; Carlo Pappone; Eric Prystowsky; Antonio Raviele; Jeremy N Ruskin; Richard J Shemin Journal: Heart Rhythm Date: 2007-04-30 Impact factor: 6.343
Authors: Stefano Benussi; Patrizio Mazzone; Giuseppe Maccabelli; Pasquale Vergara; Antonio Grimaldi; Alberto Pozzoli; Pietro Spagnolo; Ottavio Alfieri; Paolo Della Bella Journal: Circulation Date: 2011-04-12 Impact factor: 29.690
Authors: Gorav Ailawadi; Marc W Gerdisch; Richard L Harvey; Robert L Hooker; Ralph J Damiano; Thomas Salamon; Michael J Mack Journal: J Thorac Cardiovasc Surg Date: 2011-09-08 Impact factor: 5.209
Authors: Luigi Di Biase; J David Burkhardt; Prasant Mohanty; Javier Sanchez; Sanghamitra Mohanty; Rodney Horton; G Joseph Gallinghouse; Shane M Bailey; Jason D Zagrodzky; Pasquale Santangeli; Steven Hao; Richard Hongo; Salwa Beheiry; Sakis Themistoclakis; Aldo Bonso; Antonio Rossillo; Andrea Corrado; Antonio Raviele; Amin Al-Ahmad; Paul Wang; Jennifer E Cummings; Robert A Schweikert; Gemma Pelargonio; Antonio Dello Russo; Michela Casella; Pietro Santarelli; William R Lewis; Andrea Natale Journal: Circulation Date: 2010-07-06 Impact factor: 29.690
Authors: Sacha P Salzberg; Alan Marc Gillinov; Anelechi Anyanwu; Javier Castillo; Farzan Filsoufi; David H Adams Journal: Eur J Cardiothorac Surg Date: 2008-08-06 Impact factor: 4.191
Authors: David R Holmes; Vivek Y Reddy; Zoltan G Turi; Shephal K Doshi; Horst Sievert; Maurice Buchbinder; Christopher M Mullin; Peter Sick Journal: Lancet Date: 2009-08-15 Impact factor: 79.321