Safety and feasibility of radiofrequency redo pulmonary vein isolation ablation for atrial fibrillation after Amulet implantation and device electrical characteristics

Pietrasik, Grzegorz; Huang, Henry; Rodriguez, Jason; Sharma, Parikshit S.; Trohman, Richard G.; Krishnan, K. Ranga Rama

doi:10.1016/j.hrcr.2020.03.019

Cited by 6 publications

(6 citation statements)

References 10 publications

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“…Unlike the Watchman device, the Amulet device exhibited no cardiac tissue or electrogram recording on its exterior. Anatomical variances do not have a substantial impact on the device's overall efficacy for preventing stroke, and later investigations into incomplete LAAO or peridevice leakage have not demonstrated any substantial increases in long‐term adverse events 39 …”

Section: Discussionmentioning

confidence: 99%

“…Anatomical variances do not have a substantial impact on the device's overall efficacy for preventing stroke, and later investigations into incomplete LAAO or peridevice leakage have not demonstrated any substantial increases in long-term adverse events. 39 Postoperative antithrombotic treatment differed for the two devices and for each study. After Amulet installation, patients are commonly instructed to initiate dual antiplatelet treatment followed by single aspirin therapy; Following Watchman implant, patients usually take OAC over 45 days prior switching to dual antiplatelet treatment and then aspirin.…”

Section: Discussionmentioning

confidence: 99%

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Safety and efficacy of the Amplatzer Amulet and Watchman 2.5 for left atrial appendage occlusion: A systematic review and meta‐analysis

Zhu

Song

et al. 2022

Pacing Clinical Electrophis

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Background Left atrial appendage occlusion (LAAO) is an alternative to oral anticoagulation (OAC) to decrease the risk of stroke in patients with nonvalvular atrial fibrillation (NVAF); however, certain complications remain a concern. Amplatzer Amulet and Watchman are the two most popular used devices for preventing stroke in patients with NVAF. We assessed the safety and efficacy of LAAO using the Amplatzer Amulet and Watchman. Methods A meta‐analysis was conducted to compare the safety and efficacy outcomes associated with the use of the Amplatzer Amulet and Watchman 2.5. The Newcastle‐Ottawa Scale has been utilized to assess the quality of study. Results The meta‐analysis includes seven studies involving 2926 patients (1418 patients with an amulet and 1508 with a Watchman 2.5). Generally, adverse event rates for both systems were minimal. No significant differences between the two devices were found in safety (pericardial effusion, device embolization, and cardiac tamponade) or efficacy outcomes (death, TIA, stroke, major/minor bleeding, device leak, and thromboembolic events). Conclusions The data suggest LAAO is a safe procedure, regardless of which device was used. LAAO devices generally have low complication rates. Outcomes were comparable between the two groups with no significant differences in their safety or efficacy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of the Amplatzer Amulet and Watchman 2.5 for left atrial appendage occlusion: A systematic review and meta‐analysis

Zhu

Song

et al. 2022

Pacing Clinical Electrophis

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“…Data regarding this issue are limited. A small number of case reports [ 8 , 9 , 10 ] and case series [ 11 , 12 , 13 , 14 , 15 ] with small samples have been carried out to investigate the feasibility and efficacy of LA CA in patients with LAAO devices. However, most patients in prior studies were implanted with nitinol cage devices (e.g., Watchman).…”

Section: Introductionmentioning

confidence: 99%

Safety and Efficacy of Left Atrial Catheter Ablation in Patients with Left Atrial Appendage Occlusion Devices

Wang¹,

He²,

Fu³

et al. 2022

JCM

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Background: Left atrial appendage occlusion (LAAO) is an alternative to oral anticoagulation for thromboembolic prevention in patients with atrial fibrillation (AF). Left atrial (LA) catheter ablation (CA) in patients with LAAO devices has not been well investigated. Here, we report on the safety and efficacy of LA CA in patients with nitinol cage or plug LAAO devices. Methods: A total of 18 patients (aged 67 ± 11 years; 14 males; 5 paroxysmal AF) with LAAO devices (nitinol cage, n = 10; nitinol plug, n = 8) and symptomatic LA tachyarrhythmias were included. Periprocedural and follow-up data were assessed. Results: A total of 20 LA CA procedures were performed at a median of 130 (63, 338) days after LAAO. The strategy of CA consisted of circumferential pulmonary vein isolation (n = 16), linear lesions (n = 14) and complex fractionated atrial electrogram ablation (n = 6). No major adverse events occurred periprocedurally. Repeated transesophageal echocardiography showed no device-related thrombus, newly developed peridevice leakage or device dislodgement. After a median follow-up period of 793 (376, 1090) days, four patients (22%) experienced LA tachyarrhythmias recurrence and two received redo LA CA. No patients suffered stroke or major bleeding events during follow-up. Conclusions: LA CA in patients with LAAO devices (either nitinol cages or nitinol plugs) seems to be safe and efficient in our single-center experience.

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“…With increased utilization of LAAO devices, the need for pulmonary vein isolation (PVI) procedures in patients with prior LAAO devices is expected to increase. Several reports have discussed the safety and feasibility of radiofrequency (RF) ablation and cryoablation procedures for this group of patients 3–9 . Complications related to inadvertent ablation over the LAAO device have been associated with RF ablation.…”

Section: Introductionmentioning

confidence: 99%

“…Several reports have discussed the safety and feasibility of radiofrequency (RF) ablation and cryoablation procedures for this group of patients. [3][4][5][6][7][8][9] Complications related to inadvertent ablation over the LAAO device have been associated with RF ablation. Laser balloon (LB) is an efficacious alternative for PVI.…”

Section: Introductionmentioning

confidence: 99%

Feasibility and safety of laser balloon pulmonary vein isolation in patients with prior left atrial appendage occlusion device implantation

Khalil

Vipparthy

Kenigsberg

et al. 2022

Cardiovasc electrophysiol

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Introduction: With the increasing adoption of left atrial appendage occlusion (LAAO) procedures and the eligibility of patients for pulmonary vein isolation (PVI) post device placement, we examined the feasibility and safety of laser balloon (LB) for PVI in patients with prior LAAO.Methods: We retrospectively examined consecutive patients with paroxysmal or persistent, drug-resistant atrial fibrillation (AF) who underwent LB PVI, after Watchman FLX device implantation at Rush University Medical Center between January 2020 and December 2021.Results: Seven patients (four persistent and three paroxysmal) with a mean age of 64 ± 11 years, predominantly male sex (86%), were included in the study. Two (29%) patients had prior cryoablation PVI with recurrence of AF. The mean CHA 2 DS 2 VASc is 2.6 ± 0.5 and the mean HAS-BLED score is 3.4 ± 0.8. The mean follow-up duration was 10 ± 7 months. The mean duration between Watchman FLX device implantation and LB PVI was 592 days. Acute first pass left pulmonary vein (PV) isolation was achieved in 100% of the procedures. There were no periprocedural complications such as death, pericardial tamponade or effusion, phrenic nerve injury, PV stenosis, device perforation or embolization, or worsening peri-device leak in any of the patients. None of the patients had AF recurrence after the blanking period. Conclusion:LB PVI was safe and effective with 100% acute isolation of left-sided veins in patients with prior LAAO device.

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Safety and feasibility of radiofrequency redo pulmonary vein isolation ablation for atrial fibrillation after Amulet implantation and device electrical characteristics

Cited by 6 publications

References 10 publications

Safety and efficacy of the Amplatzer Amulet and Watchman 2.5 for left atrial appendage occlusion: A systematic review and meta‐analysis

Safety and efficacy of the Amplatzer Amulet and Watchman 2.5 for left atrial appendage occlusion: A systematic review and meta‐analysis

Safety and Efficacy of Left Atrial Catheter Ablation in Patients with Left Atrial Appendage Occlusion Devices

Feasibility and safety of laser balloon pulmonary vein isolation in patients with prior left atrial appendage occlusion device implantation

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