Division of Cardiac Electrophysiology, Piedmont Heart Institute, Atlanta, Georgia, USA.
Division of Cardiac Electrophysiology, Piedmont Heart Institute, Atlanta, Georgia, USA.
JACC Clin Electrophysiol. 2023 Jan;9(1):111-116. doi: 10.1016/j.jacep.2022.10.026. Epub 2022 Nov 30.
Percutaneous left atrial appendage occlusion (LAAO) is contraindicated in presence of left atrial appendage (LAA) thrombus. It is often difficult to separate LAA sludge from an organized thrombus on transesophageal echocardiography. The inability to differentiate sludge from thrombus leads to patients not receiving LAAO despite contraindication to long-term anticoagulation. Retrospective 6-month follow-up outcomes are reported on patients undergoing LAAO in presence of LAA sludge cleared by isoproterenol. This study showed no increased risk of transient ischemic attack/stroke in the 6 months following LAAO in the presence of LAA sludge, which was cleared with isoproterenol. This study suggests a role for isoproterenol in differentiating sludge from thrombus.
经皮左心耳封堵术（LAAO）在左心耳（LAA）存在血栓时被禁忌。在经食管超声心动图上，通常很难将 LAA 血栓与已形成的血栓区分开来。由于无法区分血栓与血栓，尽管长期抗凝治疗存在禁忌，但仍有患者未接受 LAAO 治疗。本文报道了接受 LAAO 治疗的患者的 6 个月回顾性随访结果，这些患者的 LAA 血栓在异丙肾上腺素的作用下被清除。该研究显示，在异丙肾上腺素作用下 LAA 血栓被清除后 6 个月内，LAAO 并未增加短暂性脑缺血发作/中风的风险。该研究表明，异丙肾上腺素在区分血栓与血栓方面发挥了作用。
