Introduction Although left atrial appendage (LAA) obliteration is the
cornerstone of stroke prevention in surgical treatment of atrial
fibrillation (AF), little is known about its direct impact on
hemodynamics. In the current pilot study, we evaluated the hemodynamic
effect of LAA closure by clipping in patients undergoing hybrid AF
ablation. Methods Seven patients with paroxysmal or persistent AF were
included. Hemodynamic and intracardiac pressure measurements such as
systemic, pulmonary artery (PA), central venous and LA pressure, cardiac
output and indexed left ventricular stroke volume (LVSVi) were measured
directly before (T0) and after (T1), and 10 minutes after (T2) LAA
closure. Results Of the 7 patients (median 66 yrs), 5 were in AF at the
time of incision. There were no differences between T0 and T1, T1 and T2
and T0 and T2 for LA pressure, mean PA pressure, LVSVi and other
hemodynamic parameters such as central venous oxygenation and pressure,
or systemic arterial pressure. Conclusion In this pilot study, the
direct hemodynamic effect of LAA closure is evaluated for the first
time. Clipping of the LAA is safe and does not directly affect
hemodynamic and intracardiac pressures.
A case of a patient treated with percutaneous edge-to-edge mitral valve repair, percutaneous left atrial appendage occlusion and implantable cardioverter-defibrillator
