Xianfeng Du1, Huimin Chu2, Ping Ye3, Bin He1, Huaiqin Xu4, Shubin Jiang5, Miao Lin6, Rong Lin7, Jing Liu1, Binhao Wang1, Mingjun Feng1, Yibo Yu1, Xiaomin Chen1. 1. Ningbo First Hospital, Zhejiang University, Ningbo, 315010, China. 2. Ningbo First Hospital, Zhejiang University, Ningbo, 315010, China. Electronic address: epnbheart@163.com. 3. The Central Hospital of Wuhan, Wuhan, 325000, China. 4. The Second Affiliated Hospital of Hainan Medical University, Haikou, 570311, China. 5. The Hospital of Traditional Chinese Medicine of the Xinjiang Uygur Autonomous Region, Xinjiang Medical University, Urumchi, 830000, China. 6. Wenzhou Central Hospital, Wenzhou, 325000, China. 7. Quanzhou First Hospital, Fujian Medical University, Quanzhou, 362002, China.
Abstract
BACKGROUND/ PURPOSE: Experience in procedures combining left atrial appendage (LAA) closure (LAAC) and catheter ablation (CA) was scarce in Chinese nonvalvular atrial fibrillation (AF) patients with high risks for stroke and bleeding. We aimed to investigate the efficacy and safety of the combination therapy with LAAC and AF CA in a single procedure based on the multicenter data and medium-term follow-up results. METHODS: A total of 122 AF patients with a mean CHA2DS2-VASc score of 4.3 ± 1.4 and HAS-BLED score of 3.3 ± 1.0 were enrolled. The Watchman (n = 83) devices were implanted either before or after AF ablations in the same procedure, while the Amplatzer Cardiac Plug (ACP, n = 39) devices were implanted immediately after CA. AF recurrence and transesophageal echocardiography results were evaluated. RESULTS: All devices were successfully implanted and acute complete LAA occlusions were achieved in 115 (94.3%) of patients. Neither acute nor chronic peri-device leaks greater than 5 mm were detected. Oral anticoagulation was held in all patients but two with asymptomatic device-related thrombi, which were resolved after prolonged anticoagulation. AF-free success rate without antiarrhythmic drugs was 76.2% after a mean follow-up of 11.5 ± 6.8 months. No serious complications were observed during the follow-up. CONCLUSION: The combination therapy with LAAC and AF ablation in a single procedure was efficacious and safe in the Chinese symptomatic AF population with high risk for stroke and bleeding.
BACKGROUND/ PURPOSE: Experience in procedures combining left atrial appendage (LAA) closure (LAAC) and catheter ablation (CA) was scarce in Chinese nonvalvular atrial fibrillation (AF) patients with high risks for stroke and bleeding. We aimed to investigate the efficacy and safety of the combination therapy with LAAC and AF CA in a single procedure based on the multicenter data and medium-term follow-up results. METHODS: A total of 122 AFpatients with a mean CHA2DS2-VASc score of 4.3 ± 1.4 and HAS-BLED score of 3.3 ± 1.0 were enrolled. The Watchman (n = 83) devices were implanted either before or after AF ablations in the same procedure, while the Amplatzer Cardiac Plug (ACP, n = 39) devices were implanted immediately after CA. AF recurrence and transesophageal echocardiography results were evaluated. RESULTS: All devices were successfully implanted and acute complete LAA occlusions were achieved in 115 (94.3%) of patients. Neither acute nor chronic peri-device leaks greater than 5 mm were detected. Oral anticoagulation was held in all patients but two with asymptomatic device-related thrombi, which were resolved after prolonged anticoagulation. AF-free success rate without antiarrhythmic drugs was 76.2% after a mean follow-up of 11.5 ± 6.8 months. No serious complications were observed during the follow-up. CONCLUSION: The combination therapy with LAAC and AF ablation in a single procedure was efficacious and safe in the Chinese symptomatic AF population with high risk for stroke and bleeding.
Authors: Tatiana Busu; Safi U Khan; Muhammad Alhajji; Fahad Alqahtani; David R Holmes; Mohamad Alkhouli Journal: Am J Cardiol Date: 2020-03-14 Impact factor: 2.778