Anticoagulant therapy in patients with atrial fibrillation after resection of the left atrial appendage

2021 ◽  
Vol 14 (3) ◽  
pp. 190
Author(s):  
S.A. Vachev ◽  
A.S. Zotov ◽  
M.A. Stepanova ◽  
A.Yu. Surminova ◽  
A.V. Troitskiy
Keyword(s):  
Atrial Fibrillation ◽  
Anticoagulant Therapy ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Atrial Appendage

scholarly journals Pulmonary veins isolation with left atrial appendage closure of non-valvular atrial fibrillation

2020 ◽  
pp. 58-63
Author(s):  
Н.А. КОЧЕРГИН ◽  
В.И. ГАНЮКОВ ◽  
Т.Ю. ЧИЧКОВА ◽  
С.Е. МАМЧУР ◽  
И.Д. СЫРОВА ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Anticoagulant Therapy ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Pulmonary Veins ◽  
Integrated Approach ◽  
Atrial Appendage ◽  
Rational Approach ◽  
Atrial Arrhythmias ◽  
Treatment And Prevention

Резюме Фибрилляция предсердий (ФП) является одной из самых распространенных и сложных форм нарушения ритма, которая требует ком3 плексного подхода в лечении и профилактике осложнений. Поэтому сочетание изоляции легочных вен (ИЛВ) и эндоваскулярной окклю3 зии ушка левого предсердия (УЛП) представляется рациональным подходом в лечении больных ФП. Цель исследования. Анализ эффективности и безопасности сочетания ИЛВ и эндоваскулярной окклюзии УЛП у выборочных больных с неклапанной ФП. Материал и методы. В проспективное обсервационное одноцентровое исследование включены 30 пациентов с неклапанной ФП и высо3 ким риском геморрагичесих и ишемических событий (HAS3BLED ≥3 баллов и CHA2DS23VASc ≥2 баллов). Медиана возраста пациентов составила 63 (59; 67) года. В половой структуре немногим преобладали женщины (56,6%). Конечными точками исследования были рецидив предсердной аритмии (фибрилляция или трепетание предсердий) за исключением «сле3 пого» периода (первых трех месяцев после ИЛВ) и ишемические тромбоэмболические события в течение 12 месяцев наблюдения. Результаты. По истечении 123месячного периода наблюдения у 11 (36,7%) больных после «слепого» периода зарегистрированы рецидивы предсердных аритмий. За весь период наблюдения не было выявлено серьезных осложнений, связанных с вмешательством, ишемических кардиоэмболических событий или кровотечений. Заключение. Так как оптимальный результат ИЛВ достигнут в 63,3% случаев, сохраняются риск тромбоэмболических осложнений и необходимость продолжения антикоагулянтной терапии. Сочетание ИЛВ с эндоваскулярной окклюзией УЛП является эффективной и безопасной опцией у пациентов с неклапанной ФП, особенно с предшествующим ишемическим событием и противопоказаниями к антикоагулянтной терапии. ummary Atrial fibrillation (AF) is one of the most common and complex forms of rhythm disturbances, which requires an integrated approach in the treatment and prevention of complications. Therefore, a combination of pulmonary veins isolation (PVI) and left atrial appendage (LAA) occlusion seems to be a rational approach to treating patients with AF. The aim of the study was to analyze the efficacy and safety of a combination of PVI and LAA occlusion in patients with non3valvular AF. Materials and methods. The prospective observational single3center study included 30 patients with non3valvular AF and a high risk of hemorrhagic and ischemic events (HAS3BLED ≥3 and CHA2DS23VASc ≥2). The median age of patients was 63 (59; 67) years. Women predominated in the sexual structure (56.6%). The end points of the study were recurrence of atrial arrhythmias (atrial fibrillation or flutter) with the exception of a “blind” period (the first three months after PVI) and ischemic thromboembolic events during 12 months follow3up. Results. During 13year follow3up, recurrence of atrial arrhythmias were recorded in 36.7% of cases (11 patients) after the “blind” period. Over the follow3up period, no serious complications associated with the intervention, ischemic cardioembolic events or bleeding were identified. Conclusion. Since the optimal result of PVI was achieved in 63.3% of cases, the risk of thromboembolic complications and the need to continue anticoagulant therapy remain. The combination of PVI with LAA occlusion is an effective and safe option in patients with non3valvular AF, especially with a previous ischemic event and contraindications to anticoagulant therapy.

scholarly journals CLINICAL CASE OF RESUMPTION OF ANTICOAGULANT THERAPY AFTER IMPLANTATION OF THE AMPLATZER CARDIAC PLUG LEFT ATRIAL APPENDAGE OCCLUDER

2019 ◽  
pp. 82-91
Author(s):  
R. V. Guchaev ◽  
D. V. Pevzner ◽  
E. V. Merkulov ◽  
M. I. Makeev ◽  
N. S. Zhukova ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Blood Flow ◽  
Anticoagulant Therapy ◽  
Left Atrial ◽  
Clinical Case ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Thromboembolic Complications ◽  
Thrombosis Risk

The article demonstrates a clinical case of forced renewal of anticoagulant therapy after the endovascular closure of the left atrial appendage. Patient with atrial fibrillation and high risk of thromboembolic complications and bleeding on the background of warfarin administration and inappropriate INR values had an acute hemorrhagic cerebral blood flow disorder developed. Endovascular closure of the left atrial appendage was performed. However, the thrombosis of the area of the delivery system fastening revealed after 12 months was an indication for the resumption of anticoagulant therapy.The article presents modern data on the use of occluders for closing the left atrial appendage, the frequency of complications and antiplatelet therapy schemes depending on the presence of thrombosis risk factors and bleeding.

scholarly journals Thromboembolic risk of movable type left atrial appendage thrombi in patients with atrial fibrillation under widespread use of anticoagulants

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
T Mine ◽  
M Sugitami ◽  
E Fukuhara ◽  
R Kitagaki ◽  
M Ishihara
Keyword(s):  
Atrial Fibrillation ◽  
Anticoagulant Therapy ◽  
Clinical Data ◽  
Left Atrial ◽  
Thromboembolic Event ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Coagulation Disorder ◽  
Thromboembolic Risk ◽  
Fixed Type

Abstract Background Left atrial appendage thrombi (LAAT), especially movable type LAAT, have been reported to be high-risk for thromboembolic events in patients with atrial fibrillation (AF). However, thromboembolic risk of the movable-type LAAT under widespread use of anticoagulant therapy remains unclear. Methods We retrospectively studied 65 LAAT patients taking anticoagulants out of 1381 consecutive patients who underwent transthoracic echocardiography prior to cardioversion or catheter ablation for AF. Patients with significant valvular disease and coagulation disorder were excluded. Clinical data were evaluated at the time of TEE. The LAAT were classified into movable and fixed type LAAT by three independent observers. Results Sixteen of 65 LAAT patients showed movable type LAAT. During follow-up (42±34 months), one patient underwent emergency thrombectomy, 5 patients developed thromboembolic event, and 12 patients died. There were no differences in clinical data, parameters, thrombectomy/thromboembolic event, and survival rate between patients with movable and fixed type LAAT. Conclusion Thromboembolic risk of the movable-type LAAT is the same as fixed type LAAT, under widespread use of anticoagulant therapy. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals The first in Ukraine experience of using the Ultrasept system for occlusion of the left atrial appendage in patients with atrial fibrillation

2020 ◽  
Vol 27 (5) ◽  
pp. 71-77
Author(s):  
Ye. Yu. Marushko ◽  
G. B. Mankovsky ◽  
M. S. Meshkova ◽  
S. O. Kuzmenko ◽  
O. S. Riznyk ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Anticoagulant Therapy ◽  
Safety Profile ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Complete Occlusion ◽  
Transcatheter Occlusion ◽  
Left Atrial Appendage Occlusion ◽  
Good Safety Profile

The aim – to present the first in Ukraine experience of using the LAAO Cardia device for the procedure of the left atrial appendage occlusion in patients with atrial fibrillation.Materials and methods. The article represents clinical cases of four patients aged 24 to 68 years with atrial fibrillation and ineffective anticoagulant therapy or contraindications for it.Results and discussion. All patients underwent transcatheter occlusion of the left atrial appendage. Complete occlusion of the ostium was achieved without residual paradevice leaks. In 30–45 days after the procedure, no dislocation of the device or its thrombosis was detected.Conclusions. Cardia left atrial appendage occlusion system allows transcatheter occlusion of the left atrial appendage with good immediate results and good safety profile of the procedure.

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