Combination of catheter ablation for non‑valvular atrial fibrillation and left atrial appendage occlusion in a single procedure

  • Authors:
    • Xuexun Li
    • Jianping Li
    • Hongxia Chu
    • Lihong Wang
    • Lei Shi
    • Guangqiang Wang
    • Xiaofei Wang
  • View Affiliations

  • Published online on: June 27, 2018     https://doi.org/10.3892/etm.2018.6358
  • Pages: 2094-2100
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Abstract

Patients with atrial fibrillation (AF) have an increased risk of stroke and systemic embolism. Catheter ablation (CA) is increasingly applied for the treatment for drug‑refractory AF; however, its long‑term success rate is <50%. It has been proved that percutaneous left atrial appendage occlusion (LAAO) exerts the same efficacy as novel oral anti‑coagulants [(N)OACs] in reducing thromboembolic events. The present study investigated whether a combined procedure of AF ablation and LAAO may be feasible and efficacious. CA was performed for patients with AF and a high risk of stroke according to their CHADS2 or CHA2DS2‑VASc score, and LAAO was performed using the Watchman device. A total of 25 patients (40% females; mean age, 64.2±3.5 years) who were treated between July 2016 and June 2017 were included in the present study. The median CHA2DS2‑VASc score was 4.5 (range, 2‑6) and the median HAS‑BLED score was 3.17 (range, 1‑7). Successful CA and LAAO were performed in 100% of cases. All patients met the criteria for successful LAAO. At the 6‑month follow‑up, complete sealing of the LAA was achieved in 23 patients (92%), while a minimal residual flow (<5 mm) was detected in 2 patients (8%). In 24 patients (96%), the administration of (N)OACs was terminated and aspirin administration was initiated at the 6‑month follow‑up. (N)OAC treatment was maintained in 1 patient (4%) on the basis of transient ischemic attack. During the 6‑month follow‑up period, 3 patients who had a recurrence of AF received a repeated ablation. In conclusion, the combination of CA and LAAO in a single procedure is feasible, safe and efficacious for patients with non‑valvular AF at a high risk of stroke, and a contraindication regarding the use of (N)OACs.
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September-2018
Volume 16 Issue 3

Print ISSN: 1792-0981
Online ISSN:1792-1015

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Spandidos Publications style
Li X, Li J, Chu H, Wang L, Shi L, Wang G and Wang X: Combination of catheter ablation for non‑valvular atrial fibrillation and left atrial appendage occlusion in a single procedure. Exp Ther Med 16: 2094-2100, 2018
APA
Li, X., Li, J., Chu, H., Wang, L., Shi, L., Wang, G., & Wang, X. (2018). Combination of catheter ablation for non‑valvular atrial fibrillation and left atrial appendage occlusion in a single procedure. Experimental and Therapeutic Medicine, 16, 2094-2100. https://doi.org/10.3892/etm.2018.6358
MLA
Li, X., Li, J., Chu, H., Wang, L., Shi, L., Wang, G., Wang, X."Combination of catheter ablation for non‑valvular atrial fibrillation and left atrial appendage occlusion in a single procedure". Experimental and Therapeutic Medicine 16.3 (2018): 2094-2100.
Chicago
Li, X., Li, J., Chu, H., Wang, L., Shi, L., Wang, G., Wang, X."Combination of catheter ablation for non‑valvular atrial fibrillation and left atrial appendage occlusion in a single procedure". Experimental and Therapeutic Medicine 16, no. 3 (2018): 2094-2100. https://doi.org/10.3892/etm.2018.6358