Concomitant epicardial left atrial appendage ligation and left atrial ablation of atrial fibrillation: Safety, feasibility and outcome

Karin Nentwich; Elena Ene; Philipp Halbfass; Arthur Berkowitz; Kai Sonne; Sebastian Kerber; Randall Lee; Thomas Deneke

doi:10.1016/j.ipej.2021.01.001

Concomitant epicardial left atrial appendage ligation and left atrial ablation of atrial fibrillation: Safety, feasibility and outcome

Indian Pacing Electrophysiol J. 2021 Mar-Apr;21(2):75-79. doi: 10.1016/j.ipej.2021.01.001. Epub 2021 Jan 15.

Authors

Karin Nentwich¹, Elena Ene², Philipp Halbfass², Arthur Berkowitz², Kai Sonne², Sebastian Kerber², Randall Lee³, Thomas Deneke²

Affiliations

¹ Campus Bad Neustadt, Department Cardiology and Invasive Electrophysiology, von Guttenbergstrasse 11, 97616, Bad Neustadt, Germany. Electronic address: Karin.nentwich@campus-nes.de.
² Campus Bad Neustadt, Department Cardiology and Invasive Electrophysiology, von Guttenbergstrasse 11, 97616, Bad Neustadt, Germany.
³ Section of Cardiac Electrophysiology, Division of Cardiology, University of California, 500 Parnassus Ave, San Francisco, CA, 94143, USA.

Abstract

Introduction: We present initial results of patients undergoing a combined procedure of epicardial LAA ligation in addition to left atrial ablation for AF.

Methods: 9 patients were included for additional use of LARIAT as an individual treatment approach for AF. First an epicardial LAA ligation was performed, in the same procedure left atrial ablations consisting of PVI and additional substrate based modifying ablations were performed. Follow-up at 3 months and 12 months was performed.

Results: There was only 1 minor procedural complication (11%) involving epicardial bleeding and 2 late adverse events of pericardial tamponade and stroke. At the final follow-up (median 20 months) 7 patients were in stable sinus rhythm (78%) and 2 pts had reduced AF burden.

Conclusion: Concomitant epicardial LAA ligation and ablation is feasible in selected patients with a reasonable risk profile. More prospective data are required to validate the safety and efficacy.

Keywords: Atrial fibrillation; Lariat; Left atrial appendage; Ligation.