Walker Daniel T, Humphries Julie A, Phillips Karen P
St Jude Medical, 17 Orion Rd, Lane Cove, NSW, Australia 2066.
Greenslopes Private Hospital, Newdegate St, Greenslopes, QLD, Australia 4120.
J Atr Fibrillation. 2012 Oct 6;5(3):687. doi: 10.4022/jafib.687. eCollection 2012 Oct-Nov.
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. Twenty-six patients underwent either first time or redo pulmonary vein isolation (PVI) procedures followed by successful implant of a Watchman device. 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. 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.
心房颤动(AF)患者可能有兴趣同时接受左心房导管消融和左心耳(LAA)封堵装置治疗。我们报告了单中心病例系列中联合手术的可行性和结果。26例患者首次或再次接受肺静脉隔离(PVI)手术,随后成功植入Watchman装置。所有手术均无并发症,平均手术时间为233±38分钟。26例患者中有3例在PVI术后LAA最大开口尺寸(范围为1mm)比术前经食管超声心动图(TOE)测量的尺寸小。在6周随访TOE检查时,26例患者中有5例出现最大3mm的新的装置周围渗漏,但在6个月随访时4例渗漏消失。房颤导管消融和Watchman LAA植入联合手术似乎可行且安全,随访时LAA封堵效果良好。