scholarly journals Combined left atrial appendage closure and ablation in a patient with hemophilia B, paroxysmal atrial fibrillation, and transient ischemic attack

2019 ◽  
Vol 5 (5) ◽  
pp. 266-268 ◽  
Author(s):  
Zabeer Bhatti ◽  
Seth Goldbarg
Keyword(s):  
Atrial Fibrillation ◽  
Transient Ischemic Attack ◽  
Paroxysmal Atrial Fibrillation ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Hemophilia B ◽  
Atrial Appendage ◽  
Left Atrial Appendage Closure ◽  
Ischemic Attack

Hemodynamic impact of percutaneous left atrial appendage closure in patients with paroxysmal atrial fibrillation

2018 ◽  
Vol 53 (2) ◽  
pp. 151-157 ◽  
Author(s):  
Lluis Asmarats ◽  
Mathieu Bernier ◽  
Gilles O’Hara ◽  
Jean-Michel Paradis ◽  
Kim O’Connor ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Paroxysmal Atrial Fibrillation ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Left Atrial Appendage Closure

scholarly journals Left Atrial Appendage Morphology and Function Show an Association with Stroke and Transient Ischemic Attack in Patients with Atrial Fibrillation

2021 ◽  
Author(s):  
Judit Simon ◽  
Jeff M. Smit ◽  
Mohamed El Mahdiui ◽  
Lili Száraz ◽  
Alexander R. van Rosendael ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Flow Velocity ◽  
Transient Ischemic Attack ◽  
Left Atrial ◽  
Cardiac Ct ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Orifice Area ◽  
Ischemic Attack ◽  
And Function

Abstract BackgroundWe aimed to correlate left atrial appendage (LAA) structure and function with the history of stroke/transient ischemic attack (TIA) in patients with atrial fibrillation (AF).MethodsWe analyzed data of 649 patients with AF who were scheduled for catheter ablation. Patients underwent cardiac CT and transesophageal echocardiography prior to ablation. LAA morphologies depicted by cardiac CT were categorized into four groups: cauliflower, chicken wing, swan and windsock shapes. ResultsMean age was 61.3±10.5 years, 33.9% were female. Prevalence of stroke/TIA was 7.1%. After adjustment for the main risk factors, LAA flow velocity ≤35.3 cm/sec (OR=2.18; 95%CI=1.09-4.61; p=0.033) and swan LAA shape (OR=2.69; 95%CI=0.96-6.86; p=0.047) independently associated with higher, while windsock LAA morphology with lower risk of stroke/TIA (OR=0.32; 95%CI=0.12-0.77; p=0.017) as compared to cauliflower LAA shape. When comparing the differences between LAA morphology groups, we measured significantly smaller LAA orifice area (389.3±137.7 mm2 in windsock vs 428.3±158.9 ml in cauliflower, p=0.021) and LAA volume (7.4±3.0 mm2 in windsock vs 8.5±4.8 mm2 in cauliflower, p=0.012) in patients with windsock LAA morphology, while LAA flow velocity did not differ significantly. ConclusionReduced LAA function and swan LAA morphology were independently associated with higher, while windsock LAA shape with lower prevalence of stroke/TIA. When comparing the differences between the various LAA morphology types, significantly lower LAA volume and LAA orifice area were measured in windsock LAA shape as compared to cauliflower LAA shape.

scholarly journals Large Device-Related Thrombus Detected following Symptoms of Transient Ischemic Attack

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Osayi Lawani ◽  
Edward Baptista
Keyword(s):  
Atrial Fibrillation ◽  
Transient Ischemic Attack ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Thrombus Formation ◽  
Anticoagulation Therapy ◽  
Atrial Appendage ◽  
Management Options ◽  
Left Atrial Appendage Occlusion ◽  
Ischemic Attack

As an independent risk factor for stroke, atrial fibrillation has been shown to be associated with a fivefold increase in the cause of embolic stroke in comparison to healthy individuals without atrial fibrillation. This risk may be compounded by other factors; however, the main probable cause of stroke leading from atrial fibrillation is thrombus formation in the left atrial appendage. In patients for whom anticoagulation is contraindicated, left atrial appendage occlusion has become a leading alternative option for therapeutic prevention of thromboembolism and stroke in patients with this condition. Unfortunately, these devices (particularly the WATCHMAN) have been associated with a 3-6% incidence of intracardiac thrombus development postimplantation. Some risk factors for the development of device-related thrombus are high platelet count, permanent atrial fibrillation, resistance to clopidogrel, and prior transient ischemic attack or stroke. Despite following an anticoagulant regimen, thrombus formation was reported in 5.6% of participants of a randomized clinical trial, and further analysis showed that some of these patients continued to develop either ischemic stroke or thromboembolism five years later as compared to patients without initial thrombus development. We present a case of an elderly male with prior history of stroke and transient ischemic attack who developed a large device-related thrombus five months following WATCHMAN FLX™ implantation. Currently, there are no specific recommendations on the management of this rare complication; however, we discuss possible consideration of initially prolonging anticoagulation therapy following implantation for high-risk individuals, as there is an increased possibility for thrombus formation in this population. Management options should continue to be studied for therapeutic benefit in streamlining postprocedural therapy and improve future outcomes in the use of left atrial appendage occlusion devices, as well as continual thrombus prevention.

scholarly journals B-PO02-074 LEFT ATRIAL APPENDAGE CLOSURE IMPACT ON ATRIAL FIBRILLATION RECURRENCE-RATE IN PATIENTS UNDERGOING PULMONARY VEIN ISOLATION

Heart Rhythm ◽  
2021 ◽  
Vol 18 (8) ◽  
pp. S126
Author(s):  
Ciro Ascione ◽  
Marco Bergonti ◽  
Valentina Catto, Stefania I. Riva ◽  
Massimo Moltrasio ◽  
Fabrizio Tundo ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Recurrence Rate ◽  
Pulmonary Vein Isolation ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Atrial Fibrillation Recurrence ◽  
Left Atrial Appendage Closure

P3731The improvement in left atrial strain among patients undergoing percutaneous left atrial appendage closure

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Ijuin ◽  
A Hamadanchi ◽  
F Haertel ◽  
L Baez ◽  
C Schulze ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Transesophageal Echocardiography ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Lateral Wall ◽  
Bleeding Risk ◽  
Atrial Appendage ◽  
Left Atrial Appendage Closure ◽  
Left Atrial Strain

Abstract Background Percutaneous left atrial appendage closure (LAAC) is being established as an alternative option for atrial fibrillation (AF) patients with high bleeding risk. Few studies reported the influence of percutaneous LAAC on left atrial (LA) performance, but most of the studies demonstrated no remarkable changes in their parameters after the procedure. Method The study included 95 patients (age: 75±6.7 years, 67% male) whom underwent percutaneous LAAC in a single center between September 2012 and November 2018. LA strain was evaluated at three different time intervals by transesophageal echocardiography (baseline, 45 days and 180 days after procedure). All data were analyzed using a dedicated. 70 patients had atrial fibrillation whereas 25 were in sinus rhythm. Analysis was performed for peak atrial longitudinal strain (PALS) and peak atrial contraction strain (PACS) from segment of lateral wall in mid-esophageal 4 chamber view. The validity of lateral wall left atrial analysis was recently shown by our group. PACS was obtained in patients with sinus rhythm during exams. Results Compared to baseline, PALS was significantly increased after 45 days (12.4±8.4% vs 16.0±10.7%, p=0.001) and remained stable after 180 days (13.8±9.0% vs 17.0±12.4%, p=0.098). Even in only patients with atrial fibrillation during exams, it was increased (10.8±7.7% vs 13.4±7.1%, p=0.012 and 8.5±5.1% vs 13.9±8.1%, p=0.014). Similarly, compared with the baseline, PACS was significantly increased after 45 days and 180 days (5.8±3.9% vs 10.6±7.6%, p=0.001 and 4.5±2.6% vs 7.9±3.1%, p=0.036). The Changes in PALS and PACS Conclusion Our study has demonstrated for the first time the improvement in LA strain following LAAC within 45 days of implantation by transesophageal echocardiography and these values were maintained at least for 6 months. Further appraisal is warranted for confirmation of these preliminary findings.

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