Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang, Wenzhou, P.R. China.
The Key Laboratory of Cardiovascular Disease of Wenzhou, Nanbaixiang, Wenzhou, P.R. China.
J Cardiovasc Electrophysiol. 2021 Jun;32(6):1646-1654. doi: 10.1111/jce.15020. Epub 2021 Apr 12.
We aimed to investigate whether a modified implantation method facilitating a fully open umbrella can reduce the pericardial effusion/pericardial tamponade (PE/PT) rate after left atrial appendage closure (LAAC) with the LAmbre device compared with the conventional method (CM) in patients with non-valvular atrial fibrillation (NVAF).
Patients with NVAF who received either isolated LAAC or combined catheter ablation and LAAC using the LAmbre device at the First Affiliated Hospital of Wenzhou Medical University from January 2018 to December 2019 were enrolled. CM was used for device implantation in the initial 59 patients, while a modified method (MM) was used in the remaining 165 patients. Successful implantation was achieved in 98.3% of patients in the CM group and 98.8% in the MM group. A higher rate of a fully open umbrella (98.8% vs. 69%, p < .001), less requirement for recapture (46% vs. 62.1%, p = .036), and a lower incidence of delayed PE/PT (1.2% vs. 8.6%, p = .005) were found in the MM group compared with the CM group. All of the five delayed PT events occurred in patients with combined treatment. An umbrella that was not fully open was the only factor associated with delayed PE/PT events in a multivariable Cox model.
LAAC with the LAmbre device using an MM significantly increases the rate of a fully open umbrella and decreases the requirement for recapture and the incidence of delayed PE/PT. This method is more effective in patients with combined treatment.
我们旨在研究与传统方法（CM）相比，使用 LAmbre 装置进行左心耳封堵（LAAC）时，改良的植入方法是否能降低非瓣膜性心房颤动（NVAF）患者术后出现心包积液/心包填塞（PE/PT）的风险。
本研究纳入了 2018 年 1 月至 2019 年 12 月在温州医科大学附属第一医院接受 LAmbre 装置行单纯 LAAC 或联合导管消融及 LAAC 的 NVAF 患者。CM 用于最初 59 例患者的装置植入，而改良方法（MM）用于其余 165 例患者。CM 组 98.3%的患者成功植入装置，MM 组为 98.8%。MM 组完全打开伞的比例更高（98.8%比 69%，p<0.001），需要重新捕获的比例更低（46%比 62.1%，p=0.036），延迟性 PE/PT 的发生率更低（1.2%比 8.6%，p=0.005）。5 例延迟性 PT 事件均发生在联合治疗患者中。多变量 Cox 模型显示，伞未完全打开是延迟性 PE/PT 事件的唯一相关因素。
使用 MM 行 LAAC 与 LAmbre 装置显著增加了完全打开伞的比例，减少了重新捕获的需求，并降低了延迟性 PE/PT 的发生率。该方法在联合治疗患者中更为有效。
