Left atrial appendage ligation and ablation for persistent atrial fibrillation: The LAALA-AF registry

Dhanunjaya Lakkireddy, Arun Sridhar Mahankali, Arun Kanmanthareddy, Randall Lee, Nitish Badhwar, Krzysztof Bartus, Donita Atkins, Sudharani Bommana, Jie Cheng, Abdi Rasekh, Luigi Di Biase, Andrea Natale, Jayant Nath, Ryan Ferrell, Matthew Earnest, Yeruva Madhu Reddy

Research output: Contribution to journalArticle

56 Citations (Scopus)

Abstract

Objectives This study was intended to evaluate the impact of adding the left atrial appendage (LAA) closure system (LARIAT) procedure to conventional atrial fibrillation (AF) ablation in patients with persistent AF. Background Percutaneous endoepicardial LARIAT may result in both mechanical and electrical exclusion of the LAA and aid in improving the outcomes of catheter ablation by eradicating the LAA triggers and altering the substrate. Methods We performed a prospective observational study of patients with persistent AF referred for AF ablation. Patients underwent LAA ligation with LARIAT procedure before undergoing AF ablation (LARIAT group). Age- and sex-matched persistent AF patients undergoing AF ablation during the same time frame were included in the control group (ablation-only group). Results A total of 138 patients were included in the study, with 69 patients in the LARIAT group. The mean age of the population was 67 ± 10 years, with 96 (70%) men. Left atrial (LA) size, CHADS2, CHADSVasc, and HAS-BLED scores were higher in the LARIAT group when compared with the ablation-only group. There were no differences in the type of lesions during AF ablation between the groups. The primary outcome of freedom from AF at 1 year off antiarrhythmic therapy after 1 ablation procedure was higher in the LARIAT group (45 [65%] vs. 27 [39%]; p = 0.002). More patients in the ablation-only group underwent repeat ablation because of AF recurrence (11 [16%] vs. 23 [33%]; p = 0.018). Conclusions In patients with persistent AF, addition of LAA ligation with the LARIAT device to conventional ablation appears to improve the success rate of AF ablation.

Original languageEnglish (US)
Pages (from-to)153-160
Number of pages8
JournalJACC: Clinical Electrophysiology
Volume1
Issue number3
DOIs
StatePublished - Jun 1 2015
Externally publishedYes

Fingerprint

Atrial Appendage
Atrial Fibrillation
Ligation
Registries
Catheter Ablation
Observational Studies

Keywords

  • atrium
  • catheter ablation
  • fibrillation
  • stroke

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Lakkireddy, D., Sridhar Mahankali, A., Kanmanthareddy, A., Lee, R., Badhwar, N., Bartus, K., ... Reddy, Y. M. (2015). Left atrial appendage ligation and ablation for persistent atrial fibrillation: The LAALA-AF registry. JACC: Clinical Electrophysiology, 1(3), 153-160. https://doi.org/10.1016/j.jacep.2015.04.006

Left atrial appendage ligation and ablation for persistent atrial fibrillation : The LAALA-AF registry. / Lakkireddy, Dhanunjaya; Sridhar Mahankali, Arun; Kanmanthareddy, Arun; Lee, Randall; Badhwar, Nitish; Bartus, Krzysztof; Atkins, Donita; Bommana, Sudharani; Cheng, Jie; Rasekh, Abdi; Di Biase, Luigi; Natale, Andrea; Nath, Jayant; Ferrell, Ryan; Earnest, Matthew; Reddy, Yeruva Madhu.

In: JACC: Clinical Electrophysiology, Vol. 1, No. 3, 01.06.2015, p. 153-160.

Research output: Contribution to journalArticle

Lakkireddy, D, Sridhar Mahankali, A, Kanmanthareddy, A, Lee, R, Badhwar, N, Bartus, K, Atkins, D, Bommana, S, Cheng, J, Rasekh, A, Di Biase, L, Natale, A, Nath, J, Ferrell, R, Earnest, M & Reddy, YM 2015, 'Left atrial appendage ligation and ablation for persistent atrial fibrillation: The LAALA-AF registry', JACC: Clinical Electrophysiology, vol. 1, no. 3, pp. 153-160. https://doi.org/10.1016/j.jacep.2015.04.006
Lakkireddy, Dhanunjaya ; Sridhar Mahankali, Arun ; Kanmanthareddy, Arun ; Lee, Randall ; Badhwar, Nitish ; Bartus, Krzysztof ; Atkins, Donita ; Bommana, Sudharani ; Cheng, Jie ; Rasekh, Abdi ; Di Biase, Luigi ; Natale, Andrea ; Nath, Jayant ; Ferrell, Ryan ; Earnest, Matthew ; Reddy, Yeruva Madhu. / Left atrial appendage ligation and ablation for persistent atrial fibrillation : The LAALA-AF registry. In: JACC: Clinical Electrophysiology. 2015 ; Vol. 1, No. 3. pp. 153-160.
@article{a4acada1c0184b348dd0b95401176288,
title = "Left atrial appendage ligation and ablation for persistent atrial fibrillation: The LAALA-AF registry",
abstract = "Objectives This study was intended to evaluate the impact of adding the left atrial appendage (LAA) closure system (LARIAT) procedure to conventional atrial fibrillation (AF) ablation in patients with persistent AF. Background Percutaneous endoepicardial LARIAT may result in both mechanical and electrical exclusion of the LAA and aid in improving the outcomes of catheter ablation by eradicating the LAA triggers and altering the substrate. Methods We performed a prospective observational study of patients with persistent AF referred for AF ablation. Patients underwent LAA ligation with LARIAT procedure before undergoing AF ablation (LARIAT group). Age- and sex-matched persistent AF patients undergoing AF ablation during the same time frame were included in the control group (ablation-only group). Results A total of 138 patients were included in the study, with 69 patients in the LARIAT group. The mean age of the population was 67 ± 10 years, with 96 (70{\%}) men. Left atrial (LA) size, CHADS2, CHADSVasc, and HAS-BLED scores were higher in the LARIAT group when compared with the ablation-only group. There were no differences in the type of lesions during AF ablation between the groups. The primary outcome of freedom from AF at 1 year off antiarrhythmic therapy after 1 ablation procedure was higher in the LARIAT group (45 [65{\%}] vs. 27 [39{\%}]; p = 0.002). More patients in the ablation-only group underwent repeat ablation because of AF recurrence (11 [16{\%}] vs. 23 [33{\%}]; p = 0.018). Conclusions In patients with persistent AF, addition of LAA ligation with the LARIAT device to conventional ablation appears to improve the success rate of AF ablation.",
keywords = "atrium, catheter ablation, fibrillation, stroke",
author = "Dhanunjaya Lakkireddy and {Sridhar Mahankali}, Arun and Arun Kanmanthareddy and Randall Lee and Nitish Badhwar and Krzysztof Bartus and Donita Atkins and Sudharani Bommana and Jie Cheng and Abdi Rasekh and {Di Biase}, Luigi and Andrea Natale and Jayant Nath and Ryan Ferrell and Matthew Earnest and Reddy, {Yeruva Madhu}",
year = "2015",
month = "6",
day = "1",
doi = "10.1016/j.jacep.2015.04.006",
language = "English (US)",
volume = "1",
pages = "153--160",
journal = "JACC: Clinical Electrophysiology",
issn = "2405-5018",
publisher = "Elsevier USA",
number = "3",

}

TY - JOUR

T1 - Left atrial appendage ligation and ablation for persistent atrial fibrillation

T2 - The LAALA-AF registry

AU - Lakkireddy, Dhanunjaya

AU - Sridhar Mahankali, Arun

AU - Kanmanthareddy, Arun

AU - Lee, Randall

AU - Badhwar, Nitish

AU - Bartus, Krzysztof

AU - Atkins, Donita

AU - Bommana, Sudharani

AU - Cheng, Jie

AU - Rasekh, Abdi

AU - Di Biase, Luigi

AU - Natale, Andrea

AU - Nath, Jayant

AU - Ferrell, Ryan

AU - Earnest, Matthew

AU - Reddy, Yeruva Madhu

PY - 2015/6/1

Y1 - 2015/6/1

N2 - Objectives This study was intended to evaluate the impact of adding the left atrial appendage (LAA) closure system (LARIAT) procedure to conventional atrial fibrillation (AF) ablation in patients with persistent AF. Background Percutaneous endoepicardial LARIAT may result in both mechanical and electrical exclusion of the LAA and aid in improving the outcomes of catheter ablation by eradicating the LAA triggers and altering the substrate. Methods We performed a prospective observational study of patients with persistent AF referred for AF ablation. Patients underwent LAA ligation with LARIAT procedure before undergoing AF ablation (LARIAT group). Age- and sex-matched persistent AF patients undergoing AF ablation during the same time frame were included in the control group (ablation-only group). Results A total of 138 patients were included in the study, with 69 patients in the LARIAT group. The mean age of the population was 67 ± 10 years, with 96 (70%) men. Left atrial (LA) size, CHADS2, CHADSVasc, and HAS-BLED scores were higher in the LARIAT group when compared with the ablation-only group. There were no differences in the type of lesions during AF ablation between the groups. The primary outcome of freedom from AF at 1 year off antiarrhythmic therapy after 1 ablation procedure was higher in the LARIAT group (45 [65%] vs. 27 [39%]; p = 0.002). More patients in the ablation-only group underwent repeat ablation because of AF recurrence (11 [16%] vs. 23 [33%]; p = 0.018). Conclusions In patients with persistent AF, addition of LAA ligation with the LARIAT device to conventional ablation appears to improve the success rate of AF ablation.

AB - Objectives This study was intended to evaluate the impact of adding the left atrial appendage (LAA) closure system (LARIAT) procedure to conventional atrial fibrillation (AF) ablation in patients with persistent AF. Background Percutaneous endoepicardial LARIAT may result in both mechanical and electrical exclusion of the LAA and aid in improving the outcomes of catheter ablation by eradicating the LAA triggers and altering the substrate. Methods We performed a prospective observational study of patients with persistent AF referred for AF ablation. Patients underwent LAA ligation with LARIAT procedure before undergoing AF ablation (LARIAT group). Age- and sex-matched persistent AF patients undergoing AF ablation during the same time frame were included in the control group (ablation-only group). Results A total of 138 patients were included in the study, with 69 patients in the LARIAT group. The mean age of the population was 67 ± 10 years, with 96 (70%) men. Left atrial (LA) size, CHADS2, CHADSVasc, and HAS-BLED scores were higher in the LARIAT group when compared with the ablation-only group. There were no differences in the type of lesions during AF ablation between the groups. The primary outcome of freedom from AF at 1 year off antiarrhythmic therapy after 1 ablation procedure was higher in the LARIAT group (45 [65%] vs. 27 [39%]; p = 0.002). More patients in the ablation-only group underwent repeat ablation because of AF recurrence (11 [16%] vs. 23 [33%]; p = 0.018). Conclusions In patients with persistent AF, addition of LAA ligation with the LARIAT device to conventional ablation appears to improve the success rate of AF ablation.

KW - atrium

KW - catheter ablation

KW - fibrillation

KW - stroke

UR - http://www.scopus.com/inward/record.url?scp=84939650599&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84939650599&partnerID=8YFLogxK

U2 - 10.1016/j.jacep.2015.04.006

DO - 10.1016/j.jacep.2015.04.006

M3 - Article

AN - SCOPUS:84939650599

VL - 1

SP - 153

EP - 160

JO - JACC: Clinical Electrophysiology

JF - JACC: Clinical Electrophysiology

SN - 2405-5018

IS - 3

ER -