Sunday, August 4, 2013

Combined Catheter Ablation for Atrial Fibrillation and Watchman® Left Atrial Appendage Occlusion Procedures: A Single Centre Experience

Citation : Daniel T. Walker B. App Sci, Julie A. Humphries, Karen P. Phillips

Background : Patients with atrial fibrillation (AF) may be interested in undergoing concomitant interventions of left atrial catheter ablation and device occlusion of the left atrial appendage (LAA). We report on the feasibility and outcome of combined procedures in a single centre case series

Methods: Twenty-six patients underwent either first time or redo pulmonary vein isolation (PVI) procedures followed by successful implant of a Watchman® device.

Results: All procedures were uncomplicated with a mean case time of 233 ± 38 minutes. Maximal LAA orifice dimension was smaller in 3 of 26 patients post PVI (range 1mm) than on the pre-procedural transoesophageal echocardiogram (TOE). A new peri-device leak of maximum 3mm was noted in 5 of 26 patients at 6 week follow-up TOE, but resolved in 4 by the 6 month follow-up.

Conclusion: Combined procedures for catheter ablation for AF and Watchman® LAA implant appear to be feasible and safe with satisfactory occlusion of the LAA maintained at follow-up.

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