Introduction: Watchman FLX has been recently approved for left atrial appendage occlusion (LAAO) in the US. Intracardiac echocardiography (ICE) - which is already commonly used to guide trans-septal access - can serve as an alternative to TEE, simplifying the procedure and reducing associated costs. Herein, we report our experience with ICE-guided LAAO with Watchman FLX.
Methods And Results: This cohort study included the first 190 consecutive patients who underwent LAAO with Watchman FLX in our center. LAAO was successful in all patients without significant peri-procedural, device-related complications in either group. Compared to TEE, we observed a significant reduction in procedural times when using ICE. In addition, there was a potentially clinically relevant reduction in fluoroscopy dose, mainly secondary to fewer cine acquisition runs. At follow-up, no cases of device embolism were noted, whereas the rate of device-related thrombosis and peri-device leaks were comparable between groups.
Conclusion: ICE-guided LAAO with Watchman FLX is safe and feasible, with a significant reduction in procedural time and potential reduction in fluoroscopy dose when compared to TEE.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1111/jce.15220 | DOI Listing |
Heart Rhythm O2
December 2024
Department of Electrophysiology, North Mississippi Medical Center, Tupelo, Mississippi.
Background: Historically, percutaneous transcatheter left atrial appendage closure (LAAC) has been performed under general anesthesia (GA) with transesophageal echocardiographic images obtained by a noninvasive cardiologist and usually requires an overnight hospital stay. Alternatively, we present our single-center experience performing LAACs under deep sedation (DS), employing an echocardiographic technician instead of a noninvasive cardiologist, and expediting same-day discharge. Mid- to long-term outcomes were also evaluated with follow-up imaging at a 45-day visit.
View Article and Find Full Text PDFCJC Open
December 2024
Schulich Heart Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Background: Cardiac computed tomography imaging with contrast is being used increasingly to image left atrial appendage occlusion (LAAO) devices. Contrast flow across a device, also known as a transfabric leak (TFL), may indicate a lack of complete LAAO-device endothelialization. The data on the rate, predictors, and clinical events associated with TFL are limited.
View Article and Find Full Text PDFJ Am Heart Assoc
December 2024
Section of Cardiovascular Medicine Yale University School of Medicine, New Haven, Connecticut and Center for Outcomes Research and Evaluation, Yale-New Haven Hospital New Haven CT USA.
Background: Left atrial appendage occlusion (LAAO) is increasingly used as an alternative to oral anticoagulation for stroke prevention in select patients with atrial fibrillation. Data on outcomes in racial and ethnic minority individuals are limited. This analysis assessed differences in the use and outcomes of LAAO by race and ethnicity in a large national registry.
View Article and Find Full Text PDFJACC Cardiovasc Interv
October 2024
Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA; Center for Outcomes Research and Evaluation, Yale New Haven Health Services Corporation, New Haven, CT, USA.
J Cardiovasc Electrophysiol
December 2024
Heart & Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Introduction: Real-world studies comparing safety and efficacy of combined percutaneous left atrial appendage occlusion (LAAO) and catheter ablation (CA) to LAAO alone are limited.
Methods: Patients from a large US hospital system undergoing combined LAAO and left-atrial CA from 8/2020 to 2/2024 were retrospectively analyzed and compared to a control group undergoing LAAO alone. Controls were identified using a 1:2 propensity score match based on LAAO device type (Watchman FLX vs.
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!