Use of intracardiac echocardiography to guide implantation of a left atrial appendage occlusion device (PLAATO)

Ho, Ivan; Neužil, Petr; Mráz, Tomáš; Beldova, Zuzana; Gross, Dan; Formánek, Pavel; Táborský, Miloš; Niederle, P; Ruskin, Jeremy N.; Reddy, Vivek Y.

doi:10.1016/j.hrthm.2007.01.014

Cited by 61 publications

(49 citation statements)

References 10 publications

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“…Nonetheless, there have been selected cases outside clinical trials in which the device has been placed with the use of fluoroscopy plus ICE. 20 Our findings suggest that ICE might be a reasonable alternative in the future, The development of multiplanar or 3-dimensional ICE probes might make it possible to routinely implant the device without TEE. But for now, it should be emphasized that there is no well-studied large clinical experience with device implantation without TEE guidance; thus, our findings should be confirmed prospectively.…”

Section: Discussionmentioning

confidence: 70%

Utilization and Adverse Outcomes of Percutaneous Left Atrial Appendage Closure for Stroke Prevention in Atrial Fibrillation in the United States

Badheka

Chothani

Mehta

et al. 2015

Circ: Arrhythmia and Electrophysiology

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Section: Discussionmentioning

confidence: 70%

Utilization and Adverse Outcomes of Percutaneous Left Atrial Appendage Closure for Stroke Prevention in Atrial Fibrillation in the United States

Badheka

Chothani

Mehta

et al. 2015

Circ: Arrhythmia and Electrophysiology

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“…Certainly, intracardiac echocardiography is an alternative using unusual visualization planes, eg, from the coronary sinus or directly from within the left atrium, sometimes after a second transseptal puncture. 14 However, the present generation of single-plane intracardiac echocardiography probe does not allow facile multiplane accurate measurement of the LAA ostium, which is oval rather than round. Nonetheless, there have been selected cases outside these clinical trials in which the device has been placed with the use of fluoroscopy plus intracardiac echocardiography guidance (V.Y.R., P.N., and S.K.D., unpublished observation).…”

Section: Limitationsmentioning

confidence: 98%

Safety of Percutaneous Left Atrial Appendage Closure

Holmes²,

et al. 2011

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Background-The Watchman Left Atrial Appendage System for Embolic Protection in Patients With AF (PROTECT AF)randomized trial compared left atrial appendage closure against warfarin in atrial fibrillation (AF) patients with CHADS 2 Ն1. Although the study met the primary efficacy end point of being noninferior to warfarin therapy for the prevention of stroke/systemic embolism/cardiovascular death, there was a significantly higher risk of complications, predominantly pericardial effusion and procedural stroke related to air embolism. Here, we report the influence of experience on the safety of percutaneous left atrial appendage closure. Methods and Results-The study cohort for this analysis included patients in the PROTECT AF trial who underwent attempted device left atrial appendage closure (nϭ542 patients) and those from a subsequent nonrandomized registry of patients undergoing Watchman implantation (Continued Access Protocol [CAP] Registry; nϭ460 patients). The safety end point included bleeding-and procedure-related events (pericardial effusion, stroke, device embolization).There was a significant decline in the rate of procedure-or device-related safety events within 7 days of the procedure across the 2 studies, with 7.7% and 3.7% of patients, respectively, experiencing events (Pϭ0.007), and between the first and second halves of PROTECT AF and CAP, with 10.0%, 5.5%, and 3.7% of patients, respectively, experiencing events (Pϭ0.006). The rate of serious pericardial effusion within 7 days of implantation, which had made up Ͼ50% of the safety events in PROTECT AF, was lower in the CAP Registry (5.0% versus 2.2%, respectively; Pϭ0.019). There was a similar experience-related improvement in procedure-related stroke (0.9% versus 0%, respectively; Pϭ0.039). Finally, the functional impact of these safety events, as defined by significant disability or death, was statistically superior in the Watchman group compared with the warfarin group in PROTECT AF. This remained true whether significance was defined as a change in the modified Rankin score of Ն1, Ն2, or Ն3 (1.8 versus 4.3 events per 100 patient-years; relative risk, 0.43; 95% confidence interval, 0.24 to 0.82; 1.5 versus 3.7 events per 100 patient-years; relative risk, 0.41; 95% confidence interval, 0.22 to 0.82; and 1.4 versus 3.3 events per 100 patient-years; relative risk, 0.43; 95% confidence interval, 0.22 to 0.88, respectively). Conclusion-As

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“…LAA closure with ICE guidance has been reported in case reports or small case series with ICE performed from the right atrium (RA), 7,8 pulmonary artery, 9 or other right-sided locations. 10 More recently, Berti et al published a larger experience of LAA closure using right atrial ICE guidance, 11 reporting a technical success rate of 97.5% (117 of 121). However, visualization of the LAA from the RA and/or coronary sinus might be suboptimal and assessment of peri-device leaks could be difficult.…”

Section: R Esum Ementioning

confidence: 99%

Transcatheter Left Atrial Appendage Closure Using Intracardiac Echocardiographic Guidance From the Left Atrium

Masson

Kouz

Riahi

et al. 2015

Canadian Journal of Cardiology

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Use of intracardiac echocardiography to guide implantation of a left atrial appendage occlusion device (PLAATO)

Cited by 61 publications

References 10 publications

Utilization and Adverse Outcomes of Percutaneous Left Atrial Appendage Closure for Stroke Prevention in Atrial Fibrillation in the United States

Utilization and Adverse Outcomes of Percutaneous Left Atrial Appendage Closure for Stroke Prevention in Atrial Fibrillation in the United States

Safety of Percutaneous Left Atrial Appendage Closure

Transcatheter Left Atrial Appendage Closure Using Intracardiac Echocardiographic Guidance From the Left Atrium

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