GW28-e1156 The Clinical Application of Left Atrial Appendage Occlusion in Patients with Congenital Heart Disease and Atrial Fibrillation

AbstractLeft atrial appendage membrane is a rare anomaly. Its implications on clinical course are unknown. We report the first paediatric case in association with a congenital heart disease.

Download Full-text

Postoperative Pulmonary Hypertensive Crisis Caused by Inverted Left Atrial Appendage After Cardiopulmonary Bypass Surgery for Congenital Heart Disease in a Neonate

Heart Lung and Circulation ◽

10.1016/j.hlc.2013.03.006 ◽

2013 ◽

Vol 22 (9) ◽

pp. 781-783 ◽

Cited By ~ 4

Author(s):

Qifeng Zhao ◽

Xingti Hu

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Cardiopulmonary Bypass ◽

Left Atrial ◽

Congenital Heart ◽

Bypass Surgery ◽

Left Atrial Appendage ◽

Hypertensive Crisis ◽

Atrial Appendage ◽

Pulmonary Hypertensive Crisis

Download Full-text

Percutaneous left atrial appendage occlusion in nonvalvular atrial fibrillation patients with coronary heart disease

10.21203/rs.3.rs-19476/v1 ◽

2020 ◽

Author(s):

Juan Zhang ◽

Xiaomin Jiang ◽

Dujiang Xie ◽

Jie Luo ◽

Ling Zhou

Keyword(s):

Atrial Fibrillation ◽

Coronary Heart Disease ◽

Heart Disease ◽

Left Atrial ◽

Left Atrial Appendage ◽

Oral Anticoagulants ◽

Atrial Appendage ◽

Nonvalvular Atrial Fibrillation ◽

End Point ◽

Left Atrial Appendage Occlusion

Abstract Purpose To evaluate the 12-month outcomes of the percutaneous left atrial appendage occlusion (LAAO) procedure in nonvalvular atrial fibrillation (NVAF) patients with coronary heart disease (CAD). Materials and Methods 51 NVAF patients were consecutively accepted LAAO between June 2015 and July 2017. Patients were devided in two groups: 15 with CAD and 36 without CAD. All patients were followed up at 1st, 3rd, 6th, and 12th month after discharge with transesophageal echocardiography (TEE) examination repeated at the same time. Results Among these 51 patients (average age 64.4±10.0, 33.3% female), the procedural success rate was 98% (50/51). During 12-month follow-up, there were no hemorrhagic stroke or major bleeding. The risk of thromboembolism based on CHA2DS2-VASc score (3.1±1.6 vs. 5.2±1.1, P<0.001) and the risk of hemorrhage based on HAS-BLED score (2.2±1.2 vs. 3.1±1.0, P=0.009) in CAD group were significantly higher. The incidence of end-point events had no statistical difference between CAD and non-CAD. Compared with CAD patients who accepted long-term antithrombotic medication, there was no obvious difference in stroke rate and mortality in CAD accepted LAAO group, whereas a further reduction of hemorrhage (n=5/20% vs. n=0, P=0.039) was shown. A significant correlation (P<0.001, r=0.580) was detected between moderate or severe left atrial spontaneous echo contrast (LASEC) and the composite end point events. Conclusion There are similar safety and effectiveness for LAAO procedure in NVAF patients with CAD and without CAD under new oral anticoagulants applied post-implantation anticoagulation strategy. Meanwhile, LASEC is a predictive factor of LAAO in NVAF patients combined CAD.

Download Full-text

Double-blind, placebo-controlled randomised clinical trial to evaluate the effect of ASPIRIN discontinuation after left atrial appendage occlusion in atrial fibrillation: protocol of the ASPIRIN LAAO trial

BMJ Open ◽

10.1136/bmjopen-2020-044695 ◽

2021 ◽

Vol 11 (3) ◽

pp. e044695

Author(s):

Mu Chen ◽

Qunshan Wang ◽

Jian Sun ◽

Peng-Pai Zhang ◽

Wei Li ◽

...

Keyword(s):

Atrial Fibrillation ◽

Left Atrial ◽

Left Atrial Appendage ◽

Ethics Committee ◽

Aspirin Therapy ◽

Atrial Appendage ◽

Control Group ◽

Coronary Syndrome ◽

Left Atrial Appendage Occlusion ◽

Increased Risk

IntroductionIt is the common clinical practice to prescribe indefinite aspirin for patients with non-valvular atrial fibrillation (NVAF) post left atrial appendage occlusion (LAAO). However, aspirin as a primary prevention strategy for cardiovascular diseases has recently been challenged due to increased risk of bleeding. Therefore, aspirin discontinuation after LAAO in atrial fibrillation (ASPIRIN LAAO) trial is designed to assess the uncertainty about the risks and benefits of discontinuing aspirin therapy at 6 months postimplantation with a Watchman LAAO device in NVAF patients.Methods and analysisThe ASPIRIN LAAO study is a prospective, multicentre, randomised, double-blinded, placebo-controlled non-inferiority trial. Patients implanted with a Watchman device within 6 months prior to enrollment and without pre-existing conditions requiring long-term aspirin therapy according to current guidelines are eligible for participating the trial. Subjects will be randomised in a 1:1 allocation ratio to either the Aspirin group (aspirin 100 mg/day) or the control group (placebo) at 6 months postimplantation. A total of 1120 subjects will be enrolled from 12 investigational sites in China. The primary composite endpoint is stroke, systemic embolism, cardiovascular/unexplained death, major bleeding, acute coronary syndrome and coronary or periphery artery disease requiring revascularisation at 24 months. Follow-up visits are scheduled at 6 and 12 months and then every 12 months until 24 months after the last patient recruitment.Ethics and disseminationEthics approval was obtained from the Ethics Committee of Xinhua Hospital, Shanghai, China (reference number XHEC-C-2018-065-5). The protocol is also submitted and approved by the institutional Ethics Committee at each participating centre. Results are expected in 2024 and will be disseminated through peer-reviewed journals and presentations at national and international conferences.Trial registration numberNCT03821883.

Download Full-text

Light and electron microscopic features of surgically excised left atrial appendage in rheumatic heart disease patients with atrial fibrillation and sinus rhythm

Cardiovascular Pathology ◽

10.1016/j.carpath.2014.07.008 ◽

2014 ◽

Vol 23 (6) ◽

pp. 319-326 ◽

Cited By ~ 15

Author(s):

Shruti Sharma ◽

Gautam Sharma ◽

Milind Hote ◽

V Devagourou ◽

Vikas Kesari ◽

...

Keyword(s):

Atrial Fibrillation ◽

Heart Disease ◽

Sinus Rhythm ◽

Rheumatic Heart Disease ◽

Left Atrial ◽

Left Atrial Appendage ◽

Atrial Appendage ◽

Electron Microscopic ◽

Microscopic Features ◽

Rheumatic Heart

Download Full-text

The clinical and etiological profile of atrial fibrillation after echocardiography in a tertiary care centre from North India - a cross sectional observational study

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20170623 ◽

2017 ◽

Vol 5 (3) ◽

pp. 847 ◽

Cited By ~ 2

Author(s):

Ranvijay Singh ◽

Rajesh Kashyap ◽

Rajeev Bhardwaj ◽

Rajeev Marwaha ◽

Manish Thakur ◽

...

Keyword(s):

Atrial Fibrillation ◽

Heart Disease ◽

Left Atrial ◽

Left Atrial Appendage ◽

Tertiary Care ◽

Hypertensive Heart Disease ◽

Atrial Appendage ◽

North India ◽

Left Atrial Enlargement ◽

Atrial Enlargement

Background: Atrial fibrillation (AF) is the most common sustained arrhythmia in clinical practice. In western countries, rheumatic heart disease (RHD) is a rare cause of atrial fibrillation but in developing countries like India it is one of the commonest cause of atrial fibrillation. We studied etiology, left atrial size and the incidence of left atrial appendage clot in patients with atrial fibrillation at our institution so that guidelines could be formulated to manage the patients of AF in the hours of emergency.Methods: 110 consecutive patients of atrial fibrillation coming to emergency, cardiology and medicine outpatient department over a period of one year were enrolled for the study. Ethical committee clearance was taken. Detailed history were taken, clinical presentation reviewed and examination were carried out. All patients were subjected to transthoracic echocardiography and for transesophageal echocardiography if required.Results: The mean age of patients in the study was 58.42±14.27 years (range 22-90 years). Maximum numbers of patients were in the age group of 61-70 years (26.37%). Out of 110 patients with atrial fibrillation, 72 patients (65.46%) were females and 38 patients (34.54%) were males. Majority of patients presented with more than one symptom. Out of 110, 66 patients (60%) had RHD. Among RHD patients, 50 patients (45.55%) were females and 16 patients (14.55%) were males. Next common causes were hypertensive heart disease and degenerative valvular heart disease.Conclusions: In our study RHD was the most common cause of atrial fibrillation, followed by hypertensive heart disease and degenerative valvular heart disease. Mitral valve involvement was seen in all patients of RHD. Left atrial enlargement was seen in majority of patients, so left atrial enlargement could be a predictor of atrial fibrillation. Patients of left atrial enlargement are more prone to develop left atrial appendage clot.

Download Full-text