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
N1 - Funding Information:
Dr. Lakkireddy has received a research grant and a modest speakers honorarium from SentreHEART . Dr. Lee is a consultant for and has equity in SentreHEART. Dr. Bartus is a consultant for SentreHEART. Dr. Di Biase is a consultant for Biosense Webster, Boston Scientific, and St. Jude Medical; and has received speaker honoraria/travel fees from Medtronic, AtriCure, EPiEP, and Biotronik. Dr. Natale has received speaker honoraria from Boston Scientific, Biosense Webster, St. Jude Medical, Biotronik, and Medtronic; and is a consultant for Biosense Webster, St. Jude Medical, and Janssen. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
Publisher Copyright:
© 2015 American College of Cardiology Foundation Published By Elsevier Inc.
PY - 2015/6
Y1 - 2015/6
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
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U2 - 10.1016/j.jacep.2015.04.006
DO - 10.1016/j.jacep.2015.04.006
M3 - Article
AN - SCOPUS:84939650599
SN - 2405-5018
VL - 1
SP - 153
EP - 160
JO - JACC: Clinical Electrophysiology
JF - JACC: Clinical Electrophysiology
IS - 3
ER -