Early experience using a left atrial appendage occlusion device in patients with atrial fibrillation

Yung Ly Kim, Boyoung Joung, Young Keun On, Chi Young Shim, Moon Hyoung Lee, Young Hoon Kim, Hui Nam Pak

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Purpose: Atrial fibrillation (AF) is one of the major risk factors for ischemic stroke, and 90% of thromboembolisms in these patients arise from the left atrial appendage (LAA). Recently, it has been documented that an LAA occlusion device (OD) is not inferior to warfarin therapy, and that it reduces mortality and risk of stroke in patients with AF. Materials and Methods: We implanted LAA-ODs in 5 Korean patients (all male, 59.8±7.3 years old) with long-standing persistent AF or permanent AF via a percutaneous trans-septal approach. Results: 1) The major reasons for LAA-OD implantation were high risk of recurrent stroke (80%), labile international neutralizing ratio with hemorrhage (60%), and 3/5 (60%) patients had a past history of failed cardioversion for rhythm control. 2) The mean LA size was 51.3±5.0 mm and LAA size was 25.1×30.1 mm. We implanted the LAA-OD (28.8±3.4 mm device) successfully in all 5 patients with no complications. 3) After eight weeks of anticoagulation, all patients switched from warfarin to anti-platelet agent after confirmation of successful LAA occlusion by trans-esophageal echocardiography. Conclusion: We report on our early experience with LAA-OD deployment in patients with 1) persistent or permanent AF who cannot tolerate anticoagulation despite significant risk of ischemic stroke, or 2) recurrent stroke in patients who are unable to maintain sinus rhythm.

Original languageEnglish
Pages (from-to)83-90
Number of pages8
JournalYonsei medical journal
Volume53
Issue number1
DOIs
Publication statusPublished - 2012 Jan 1

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Atrial Appendage
Atrial Fibrillation
Equipment and Supplies
Stroke
Warfarin
Electric Countershock
Thromboembolism
Echocardiography
Blood Platelets
Hemorrhage
Mortality

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

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title = "Early experience using a left atrial appendage occlusion device in patients with atrial fibrillation",
abstract = "Purpose: Atrial fibrillation (AF) is one of the major risk factors for ischemic stroke, and 90{\%} of thromboembolisms in these patients arise from the left atrial appendage (LAA). Recently, it has been documented that an LAA occlusion device (OD) is not inferior to warfarin therapy, and that it reduces mortality and risk of stroke in patients with AF. Materials and Methods: We implanted LAA-ODs in 5 Korean patients (all male, 59.8±7.3 years old) with long-standing persistent AF or permanent AF via a percutaneous trans-septal approach. Results: 1) The major reasons for LAA-OD implantation were high risk of recurrent stroke (80{\%}), labile international neutralizing ratio with hemorrhage (60{\%}), and 3/5 (60{\%}) patients had a past history of failed cardioversion for rhythm control. 2) The mean LA size was 51.3±5.0 mm and LAA size was 25.1×30.1 mm. We implanted the LAA-OD (28.8±3.4 mm device) successfully in all 5 patients with no complications. 3) After eight weeks of anticoagulation, all patients switched from warfarin to anti-platelet agent after confirmation of successful LAA occlusion by trans-esophageal echocardiography. Conclusion: We report on our early experience with LAA-OD deployment in patients with 1) persistent or permanent AF who cannot tolerate anticoagulation despite significant risk of ischemic stroke, or 2) recurrent stroke in patients who are unable to maintain sinus rhythm.",
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Early experience using a left atrial appendage occlusion device in patients with atrial fibrillation. / Kim, Yung Ly; Joung, Boyoung; On, Young Keun; Shim, Chi Young; Lee, Moon Hyoung; Kim, Young Hoon; Pak, Hui Nam.

In: Yonsei medical journal, Vol. 53, No. 1, 01.01.2012, p. 83-90.

Research output: Contribution to journalArticle

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AU - Joung, Boyoung

AU - On, Young Keun

AU - Shim, Chi Young

AU - Lee, Moon Hyoung

AU - Kim, Young Hoon

AU - Pak, Hui Nam

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N2 - Purpose: Atrial fibrillation (AF) is one of the major risk factors for ischemic stroke, and 90% of thromboembolisms in these patients arise from the left atrial appendage (LAA). Recently, it has been documented that an LAA occlusion device (OD) is not inferior to warfarin therapy, and that it reduces mortality and risk of stroke in patients with AF. Materials and Methods: We implanted LAA-ODs in 5 Korean patients (all male, 59.8±7.3 years old) with long-standing persistent AF or permanent AF via a percutaneous trans-septal approach. Results: 1) The major reasons for LAA-OD implantation were high risk of recurrent stroke (80%), labile international neutralizing ratio with hemorrhage (60%), and 3/5 (60%) patients had a past history of failed cardioversion for rhythm control. 2) The mean LA size was 51.3±5.0 mm and LAA size was 25.1×30.1 mm. We implanted the LAA-OD (28.8±3.4 mm device) successfully in all 5 patients with no complications. 3) After eight weeks of anticoagulation, all patients switched from warfarin to anti-platelet agent after confirmation of successful LAA occlusion by trans-esophageal echocardiography. Conclusion: We report on our early experience with LAA-OD deployment in patients with 1) persistent or permanent AF who cannot tolerate anticoagulation despite significant risk of ischemic stroke, or 2) recurrent stroke in patients who are unable to maintain sinus rhythm.

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