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 Diagnosis and Management of Left Atrium Appendage Thrombosis in Atrial Fibrillation Patients Undergoing Cardioversion

Medicina ◽  
2019 ◽  
Vol 55 (9) ◽  
pp. 511 ◽  
Author(s):  
Enrico Melillo ◽  
Giuseppe Palmiero ◽  
Adele Ferro ◽  
Paola Elvira Mocavero ◽  
Vittorio Monda ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Rhythm Control ◽  
Atrial Appendage ◽  
Thromboembolic Complications ◽  
Left Atrial Appendage Thrombus ◽  
Increased Risk ◽  
Pharmacological Cardioversion

Atrial fibrillation is the most common cardiac arrhythmia and is associated with an increased risk of stroke and thromboembolic complications. A rhythm control strategy with both electrical and pharmacological cardioversion is recommended for patients with symptomatic atrial fibrillation. Anticoagulant therapy for 3–4 weeks prior to cardioversion is recommended in order to avoid thromboembolic events deriving from restoring sinus rhythm. Transesophageal echocardiography has a pivotal role in this setting, excluding the presence of left atrial appendage thrombus before cardioversion. The aim of this review is to discuss the epidemiology and risk factors for left atrial appendage thrombosis, the role of echocardiography in the decision making before cardioversion, and the efficacy of different anticoagulant regimens on the detection and treatment of left atrial appendage thrombosis.

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.

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 Non-Pharmacological Therapy for Atrial Fibrillation: Managing the Left Atrial Appendage

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Sushil Allen Luis ◽  
Damian Roper ◽  
Alexander Incani ◽  
Karl Poon ◽  
Haris Haqqani ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Blood Flow ◽  
Blood Flow Velocity ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Thrombus Formation ◽  
Pharmacological Therapy ◽  
Atrial Appendage ◽  
Ageing Population ◽  
Increased Risk

The prevalence of atrial fibrillation (AF) is increasing in parallel with an ageing population leading to increased morbidity and mortality. The most feared complication of AF is stroke, with the arrhythmia being responsible for up to 20% of all ischemic strokes. An important contributor to this increased risk of stroke is the left atrial appendage (LAA). A combination of the LAA's unique geometry and atrial fibrillation leads to low blood flow velocity and stasis, which are precursors to thrombus formation. It has been hypothesized for over half a century that excision of the LAA would lead to a reduction in the incidence of stroke. It has only been in the last 20–25 years that the knowledge and technology has been available to safely carry out such a procedure. We now have a number of viable techniques, both surgical and percutaneous, which will be covered in this paper.

Chinese spirits consumption is an independent risk factor of left atrial appendage thrombosis in non-valvular atrial fibrillation patients

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
L Yang ◽  
Y Tian
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Multivariate Analysis ◽  
Catheter Ablation ◽  
Alcohol Consumption ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Increased Risk ◽  
The Relationship

Abstract Background Alcohol consumption is often associated with an increased risk of atrial fibrillation; however, its association with left atrial appendage (LAA) thrombosis in patients with non-valvular atrial fibrillation (NVAF) remains undefined. Purpose To investigate the relationship between Chinese spirits consumption and LAA thrombosis in NVAF patients. Methods 504 consecutive adult patients with NVAF undergoing first radiofrequency catheter ablation who were enrolled retrospectively from January 2016 to April 2019. LAA thrombosis was identified by transesophageal echocardiography before catheter ablation. Risk factors for LAA thrombosis were determined by uni-/multivariate analysis of data derived from a questionnaire on alcohol consumption and other risk factors for AF, and biochemical and imaging information. Results Of the 504 patients studied, 86 (17.1%) had a drinking habit, and 59 patients (11.7%) had LAA thrombosis. The proportion of alcohol drinking patients was 47.5% (28/59) in the thrombosis group and 12.7% (58/455) in the non-thrombosis group (P<0.001). In multivariate analysis, Chinese spirits consumption (≥12g daily; OR 15.025, 95% CI 6.123–36.815, P<0.001), non-paroxysmal AF (OR 8.301, 95% CI 3.946–17.460, P<0.001), AF duration (OR 1.019, 95% CI 1.010–1.027, P<0.001), CHA2DS2-VASc score (OR 2.078, 95% CI 1.625–2.658, P<0.001), and effective anticoagulation (OR 0.348, 95% CI 0.132–0.921, P=0.033) were independently associated with LAA thrombosis. Conclusions Chinese spirits consumption was independently associated with LAA thrombosis in NVAF patients. Whether avoiding alcohol consumption might reduce the occurrence of LAA thrombosis and thromboembolism in NVAF patients requires further study. Funding Acknowledgement Type of funding source: None

scholarly journals Left Atrial and Left Atrial Appendage 4D Blood Flow Dynamics in Atrial Fibrillation

2016 ◽  
Vol 9 (9) ◽  
Author(s):  
Michael Markl ◽  
Daniel C. Lee ◽  
Nicholas Furiasse ◽  
Maria Carr ◽  
Charles Foucar ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Blood Flow ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Flow Dynamics ◽  
Atrial Appendage ◽  
Blood Flow Dynamics
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