Characterization of pleural effusion after left atrial appendage exclusion using the lariat procedure

Sampath Gunda, Arun Kanmanthareddy, Ajay Vallakati, Pramod Janga, Muhammad Rizwan Afzal, Jayasree Pillarisetti, Sudharani Bommana, Donita Atkins, Matthew Earnest, Jayant Nath, Nagaraj Hosakote, Luigi Di Biase, Andrea Natale, Madhu Reddy, Randall Lee, Dhanunjaya Lakkireddy

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background The Lariat procedure is increasingly used for the exclusion of the left atrial appendage (LAA) in atrial fibrillation (AF) patients. There are anecdotal reports of pleural effusions after the Lariat procedure. However, the incidence, demographics, and pathophysiology of these effusions are largely unknown. Objective Characterization of pleural effusions in patients who underwent LAA exclusion using the Lariat procedure. Methods We report the incidence, demographics, and clinical and laboratory characteristics of patients from a multicenter prospective registry who underwent the Lariat procedure and subsequently developed pleural effusions. Results A total of 10 out of 310 (3.2%) patients developed significant pleural effusions after the Lariat procedure. The mean age of these patients was 67 ± 9, ranging from 52 to 78 years and included 5 (50%) males. Nine patients had persistent AF with median CHADS<inf>2</inf> score of 2.7 ± 1.2. The LAA was successfully ligated in all these patients. Post-Lariat procedure, 6 patients developed bilateral and 4 patients developed left-sided pleural effusions. Pleural tap revealed transudative in 2 and exudative in 6 patients. The remaining 2 patients responded to active diuresis and behaved clinically like transudative effusions. There is a statistically significant difference between the onset of pleural effusion after the Lariat procedure between tPLE versus ePLE groups (14 ± 1.2 vs. 6 ± 6, P = 0.05). Conclusion Incidence of clinically significant pleural effusion is uncommon after the Lariat procedure and can be either exudative or transudative in nature depending on the underlying mechanisms. More prospective studies are needed to study the pathophysiologic basis of development of pleural effusions after the Lariat procedure.

Original languageEnglish (US)
Pages (from-to)515-519
Number of pages5
JournalJournal of Cardiovascular Electrophysiology
Volume26
Issue number5
DOIs
StatePublished - May 1 2015
Externally publishedYes

Fingerprint

Atrial Appendage
Pleural Effusion
Atrial Fibrillation
Incidence
Demography
Diuresis
Registries
Prospective Studies

Keywords

  • anticoagulation
  • atrial fibrillation
  • atrial natriuretic peptide
  • Lariat procedure
  • left atrial appendage
  • pleural effusions
  • stroke

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Gunda, S., Kanmanthareddy, A., Vallakati, A., Janga, P., Afzal, M. R., Pillarisetti, J., ... Lakkireddy, D. (2015). Characterization of pleural effusion after left atrial appendage exclusion using the lariat procedure. Journal of Cardiovascular Electrophysiology, 26(5), 515-519. https://doi.org/10.1111/jce.12648

Characterization of pleural effusion after left atrial appendage exclusion using the lariat procedure. / Gunda, Sampath; Kanmanthareddy, Arun; Vallakati, Ajay; Janga, Pramod; Afzal, Muhammad Rizwan; Pillarisetti, Jayasree; Bommana, Sudharani; Atkins, Donita; Earnest, Matthew; Nath, Jayant; Hosakote, Nagaraj; Di Biase, Luigi; Natale, Andrea; Reddy, Madhu; Lee, Randall; Lakkireddy, Dhanunjaya.

In: Journal of Cardiovascular Electrophysiology, Vol. 26, No. 5, 01.05.2015, p. 515-519.

Research output: Contribution to journalArticle

Gunda, S, Kanmanthareddy, A, Vallakati, A, Janga, P, Afzal, MR, Pillarisetti, J, Bommana, S, Atkins, D, Earnest, M, Nath, J, Hosakote, N, Di Biase, L, Natale, A, Reddy, M, Lee, R & Lakkireddy, D 2015, 'Characterization of pleural effusion after left atrial appendage exclusion using the lariat procedure', Journal of Cardiovascular Electrophysiology, vol. 26, no. 5, pp. 515-519. https://doi.org/10.1111/jce.12648
Gunda, Sampath ; Kanmanthareddy, Arun ; Vallakati, Ajay ; Janga, Pramod ; Afzal, Muhammad Rizwan ; Pillarisetti, Jayasree ; Bommana, Sudharani ; Atkins, Donita ; Earnest, Matthew ; Nath, Jayant ; Hosakote, Nagaraj ; Di Biase, Luigi ; Natale, Andrea ; Reddy, Madhu ; Lee, Randall ; Lakkireddy, Dhanunjaya. / Characterization of pleural effusion after left atrial appendage exclusion using the lariat procedure. In: Journal of Cardiovascular Electrophysiology. 2015 ; Vol. 26, No. 5. pp. 515-519.
@article{c38ab08fddac45b1b91e8b5c78f7c10d,
title = "Characterization of pleural effusion after left atrial appendage exclusion using the lariat procedure",
abstract = "Background The Lariat procedure is increasingly used for the exclusion of the left atrial appendage (LAA) in atrial fibrillation (AF) patients. There are anecdotal reports of pleural effusions after the Lariat procedure. However, the incidence, demographics, and pathophysiology of these effusions are largely unknown. Objective Characterization of pleural effusions in patients who underwent LAA exclusion using the Lariat procedure. Methods We report the incidence, demographics, and clinical and laboratory characteristics of patients from a multicenter prospective registry who underwent the Lariat procedure and subsequently developed pleural effusions. Results A total of 10 out of 310 (3.2{\%}) patients developed significant pleural effusions after the Lariat procedure. The mean age of these patients was 67 ± 9, ranging from 52 to 78 years and included 5 (50{\%}) males. Nine patients had persistent AF with median CHADS2 score of 2.7 ± 1.2. The LAA was successfully ligated in all these patients. Post-Lariat procedure, 6 patients developed bilateral and 4 patients developed left-sided pleural effusions. Pleural tap revealed transudative in 2 and exudative in 6 patients. The remaining 2 patients responded to active diuresis and behaved clinically like transudative effusions. There is a statistically significant difference between the onset of pleural effusion after the Lariat procedure between tPLE versus ePLE groups (14 ± 1.2 vs. 6 ± 6, P = 0.05). Conclusion Incidence of clinically significant pleural effusion is uncommon after the Lariat procedure and can be either exudative or transudative in nature depending on the underlying mechanisms. More prospective studies are needed to study the pathophysiologic basis of development of pleural effusions after the Lariat procedure.",
keywords = "anticoagulation, atrial fibrillation, atrial natriuretic peptide, Lariat procedure, left atrial appendage, pleural effusions, stroke",
author = "Sampath Gunda and Arun Kanmanthareddy and Ajay Vallakati and Pramod Janga and Afzal, {Muhammad Rizwan} and Jayasree Pillarisetti and Sudharani Bommana and Donita Atkins and Matthew Earnest and Jayant Nath and Nagaraj Hosakote and {Di Biase}, Luigi and Andrea Natale and Madhu Reddy and Randall Lee and Dhanunjaya Lakkireddy",
year = "2015",
month = "5",
day = "1",
doi = "10.1111/jce.12648",
language = "English (US)",
volume = "26",
pages = "515--519",
journal = "Journal of Cardiovascular Electrophysiology",
issn = "1045-3873",
publisher = "Wiley-Blackwell",
number = "5",

}

TY - JOUR

T1 - Characterization of pleural effusion after left atrial appendage exclusion using the lariat procedure

AU - Gunda, Sampath

AU - Kanmanthareddy, Arun

AU - Vallakati, Ajay

AU - Janga, Pramod

AU - Afzal, Muhammad Rizwan

AU - Pillarisetti, Jayasree

AU - Bommana, Sudharani

AU - Atkins, Donita

AU - Earnest, Matthew

AU - Nath, Jayant

AU - Hosakote, Nagaraj

AU - Di Biase, Luigi

AU - Natale, Andrea

AU - Reddy, Madhu

AU - Lee, Randall

AU - Lakkireddy, Dhanunjaya

PY - 2015/5/1

Y1 - 2015/5/1

N2 - Background The Lariat procedure is increasingly used for the exclusion of the left atrial appendage (LAA) in atrial fibrillation (AF) patients. There are anecdotal reports of pleural effusions after the Lariat procedure. However, the incidence, demographics, and pathophysiology of these effusions are largely unknown. Objective Characterization of pleural effusions in patients who underwent LAA exclusion using the Lariat procedure. Methods We report the incidence, demographics, and clinical and laboratory characteristics of patients from a multicenter prospective registry who underwent the Lariat procedure and subsequently developed pleural effusions. Results A total of 10 out of 310 (3.2%) patients developed significant pleural effusions after the Lariat procedure. The mean age of these patients was 67 ± 9, ranging from 52 to 78 years and included 5 (50%) males. Nine patients had persistent AF with median CHADS2 score of 2.7 ± 1.2. The LAA was successfully ligated in all these patients. Post-Lariat procedure, 6 patients developed bilateral and 4 patients developed left-sided pleural effusions. Pleural tap revealed transudative in 2 and exudative in 6 patients. The remaining 2 patients responded to active diuresis and behaved clinically like transudative effusions. There is a statistically significant difference between the onset of pleural effusion after the Lariat procedure between tPLE versus ePLE groups (14 ± 1.2 vs. 6 ± 6, P = 0.05). Conclusion Incidence of clinically significant pleural effusion is uncommon after the Lariat procedure and can be either exudative or transudative in nature depending on the underlying mechanisms. More prospective studies are needed to study the pathophysiologic basis of development of pleural effusions after the Lariat procedure.

AB - Background The Lariat procedure is increasingly used for the exclusion of the left atrial appendage (LAA) in atrial fibrillation (AF) patients. There are anecdotal reports of pleural effusions after the Lariat procedure. However, the incidence, demographics, and pathophysiology of these effusions are largely unknown. Objective Characterization of pleural effusions in patients who underwent LAA exclusion using the Lariat procedure. Methods We report the incidence, demographics, and clinical and laboratory characteristics of patients from a multicenter prospective registry who underwent the Lariat procedure and subsequently developed pleural effusions. Results A total of 10 out of 310 (3.2%) patients developed significant pleural effusions after the Lariat procedure. The mean age of these patients was 67 ± 9, ranging from 52 to 78 years and included 5 (50%) males. Nine patients had persistent AF with median CHADS2 score of 2.7 ± 1.2. The LAA was successfully ligated in all these patients. Post-Lariat procedure, 6 patients developed bilateral and 4 patients developed left-sided pleural effusions. Pleural tap revealed transudative in 2 and exudative in 6 patients. The remaining 2 patients responded to active diuresis and behaved clinically like transudative effusions. There is a statistically significant difference between the onset of pleural effusion after the Lariat procedure between tPLE versus ePLE groups (14 ± 1.2 vs. 6 ± 6, P = 0.05). Conclusion Incidence of clinically significant pleural effusion is uncommon after the Lariat procedure and can be either exudative or transudative in nature depending on the underlying mechanisms. More prospective studies are needed to study the pathophysiologic basis of development of pleural effusions after the Lariat procedure.

KW - anticoagulation

KW - atrial fibrillation

KW - atrial natriuretic peptide

KW - Lariat procedure

KW - left atrial appendage

KW - pleural effusions

KW - stroke

UR - http://www.scopus.com/inward/record.url?scp=84929274071&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84929274071&partnerID=8YFLogxK

U2 - 10.1111/jce.12648

DO - 10.1111/jce.12648

M3 - Article

VL - 26

SP - 515

EP - 519

JO - Journal of Cardiovascular Electrophysiology

JF - Journal of Cardiovascular Electrophysiology

SN - 1045-3873

IS - 5

ER -