Appropriate use criteria of left atrial appendage closure devices: latest evidences

Guarracini, Fabrizio; Bonvicini, Eleonora; Preda, Alberto; Martín, Marta Jiménez; Muraglia, Simone; Casagranda, Giulia; Mochen, Marianna; Coser, Alessio; Quintarelli, Silvia; Branzoli, Stefano; Bonmassari, Roberto; Marini, Massimiliano; Mazzone, Patrizio

doi:10.1080/17434440.2023.2208748

Cited by 3 publications

(2 citation statements)

References 102 publications

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“…Therefore, OAC may fail to either prevent or resolve the thrombus. In this specific scenario, LAAC may be a potential option [ 70 , 71 ]. Major LAAC studies have excluded patients with LAA thrombosis due to the expected high risk of systemic embolization.…”

Section: Cerebral Protection In Ep Labsmentioning

confidence: 99%

Fighting Cardiac Thromboembolism during Transcatheter Procedures: An Update on the Use of Cerebral Protection Devices in Cath Labs and EP Labs

Preda,

Montalto,

Galasso

et al. 2023

Life

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Intraprocedural stroke is a well-documented and feared potential risk of cardiovascular transcatheter procedures (TPs). Moreover, subclinical neurological events or covert central nervous system infarctions are concerns related to the development of dementia, future stroke, cognitive decline, and increased risk of mortality. Cerebral protection devices (CPDs) were developed to mitigate the risk of cardioembolic embolism during TPs. They are mechanical barriers designed to cover the ostium of the supra-aortic branches in the aortic arch, but newer devices are able to protect the descending aorta. CPDs have been mainly designed and tested to provide cerebral protection during transcatheter aortic valve replacement (TAVR), but their use in both Catheterization and Electrophysiology laboratories is rapidly increasing. CPDs have allowed us to perform procedures that were previously contraindicated due to high thromboembolic risk, such as in cases of intracardiac thrombosis identified at preprocedural assessment. However, several concerns related to their employment have to be defined. The selection of patients at high risk of thromboembolism is still a subjective choice of each center. The aim of this review is to update the evidence on the use of CPDs in either Cath labs or EP labs, providing an overview of their structural characteristics. Future perspectives focusing on their possible future employment are also discussed.

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Section: Cerebral Protection In Ep Labsmentioning

confidence: 99%

Fighting Cardiac Thromboembolism during Transcatheter Procedures: An Update on the Use of Cerebral Protection Devices in Cath Labs and EP Labs

Preda,

Montalto,

Galasso

et al. 2023

Life

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“…Even if anticoagulation therapy reduces the rate of adverse events, its benefits have to be balanced with the increased risk of bleeding. Since in 90% of cases the thrombus is located in the left atrial appendage, percutaneous left atrial appendage occlusion (LAAO) raised as valid alternative to long-term anticoagulation in patients with AF and high haemorrhagic risk [2], with increasingly evolving indications [3]. LAAO has established itself over the years as an effective procedure with low complication rate including cerebrovascular embolism (CE) [4].…”

mentioning

confidence: 99%

Challenging Silent Cerebral Embolism during Left Atrial Appendage Occlusion: A Lesson from Recent Studies

Caccia,

Ruzzenenti,

Bellantonio

et al. 2024

Cardiology

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Arrhythmic Risk Stratification in Cardiac Amyloidosis: A Review of the Current Literature

Bonvicini,

Preda,

Tognola

et al. 2024

JCDD

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Cardiac amyloidosis is the most frequent infiltrative disease caused by the deposition of misfolded proteins in the cardiac tissue, leading to heart failure, brady- and tachyarrhythmia and death. Conduction disorders, atrial fibrillation (AF) and ventricular arrhythmia (VA) significantly impact patient outcomes and demand recognition. However, several issues remain unresolved regarding early diagnosis and optimal management. Extreme bradycardia is the most common cause of arrhythmic death, while fast and sustained VAs can be found even in the early phases of the disease. Risk stratification and the prevention of sudden cardiac death are therefore to be considered in these patients, although the time for defibrillator implantation is still a subject of debate. Moreover, atrial impairment due to amyloid fibrils is associated with an increased risk of AF resistant to antiarrhythmic therapy, as well as recurrent thromboembolic events despite adequate anticoagulation. In the last few years, the aging of the population and progressive improvements in imaging methods have led to increases in the diagnosis of cardiac amyloidosis. Novel therapies have been developed to improve patients’ functional status, quality of life and mortality, without data regarding their effect on arrhythmia prevention. In this review, we consider the latest evidence regarding the arrhythmic risk stratification of cardiac amyloidosis, as well as the available therapeutic strategies.

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Appropriate use criteria of left atrial appendage closure devices: latest evidences

Cited by 3 publications

References 102 publications

Fighting Cardiac Thromboembolism during Transcatheter Procedures: An Update on the Use of Cerebral Protection Devices in Cath Labs and EP Labs

Fighting Cardiac Thromboembolism during Transcatheter Procedures: An Update on the Use of Cerebral Protection Devices in Cath Labs and EP Labs

Challenging Silent Cerebral Embolism during Left Atrial Appendage Occlusion: A Lesson from Recent Studies

Arrhythmic Risk Stratification in Cardiac Amyloidosis: A Review of the Current Literature

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