Hybrid percutaneous treatment of atrial fibrillation
Ablation and occlusion of the left atrial appendage. State of the art
Abstract
Atrial fibrillation (AF) is the most commonly sustained
arrhythmia, with an incidence of 2% in the general population, with a lifetime risk of 24% in individuals over 40 years of age.
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References
1. Camm AJ, Kirchhof P, Lip GY, Schotten U, Savelieva I, Ernst S, et al. Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Europace. 2010;12:1360–1420.
2. Go AS, Hylek EM, Phillips KA, Chang Y, Henault LE, Selby JV, Singer DE. Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. JAMA. 2001;285:2370–2375.
3. Stewart S, Hart CL, Hole DJ, McMurray JJ. Population prevalence, incidence, and predictors of atrial fibrillation in the Renfrew/Paisley study. Heart. 2001;86:516–521.
4. Lloyd-Jones DM, Wang TJ, Leip EP, Larson MG, Levy D, Vasan RS, et al. Lifetime risk for development of atrial fibrillation: the Framingham Heart Study. Circulation. 2004;110:1042–1046.
5. Blackshear JL, Odell JA. Appendage obliteration to reduce stroke in cardiac surgical patients with atrial fibrillation. Ann Thorac Surg. 1996;61:755–759.
6. Wazni OM, Marrouche NF, Martin DO, Verma A, Bhargava M, Saliba W et al. Radiofrequency ablation vs antiarrhythmic drugs as first-line treatment of symptomatic atrial fibrillation: a randomized trial. JAMA 2005;293: 2634 – 40.
7. Mohanty S, Mohanty P, Di Biase L, Bai R, Santangeli P, Casella M et al. Results from a single-blind, randomized study comparing the impact of different ablation ap- proaches on long-term procedure outcome in coexistent atrial fibrillation and flutter (APPROVAL). Circulation 2013;127:1853 – 60.
8. Calkins H, Kuck KH, Cappato R, et al. 2012 HRS/EHRA/ECAS expert consensus statement on catheter and surgical ablation of atrial fibrillation: recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial design: a report of the Heart Rhythm Society (HRS) Task Force on Catheter and Surgical Ablation of Atrial Fibrillation: developed
in partnership with the European Heart Rhythm Association (EHRA), a registered branch of the European Society of Cardiology (ESC) and the European Cardiac Arrhythmia Society (ECAS); and in collaboration with the American College of Cardiology (ACC), American Heart Association
(AHA), the Asia Pacific Heart Rhythm Society (APHRS), and the Society of Thoracic Surgeons (STS): endorsed by the governing bodies of the American College of Cardiology Foundation, the American Heart Association, the European Cardiac Arrhythmia Society, the European Heart Rhythm Association, the Society of Thoracic Surgeons, the Asia Pacific Heart Rhythm Society, and the Heart Rhythm Society. Heart
Rhythm 2012;9:632-696.e21
9. Haïssaguerre M, Jaïs P, Shah DC, et al. Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins. N Engl J Med 1998;339:659-666
10. Kuck KH, Brugada J, Fürnkranz A, et al. Cryoballoon or Radiofrequency Ablation for Paroxysmal Atrial Fibrillation, N Engl J Med, 2016;374:2235–45.
11. Fürnkranz A, Brugada J, Albenque JP, et al. Rationale and design of FIRE AND ICE: A multicenter randomized trial comparing efficacy and safety of pulmonary vein isolation using a cryoballoon versus radiofrequency ablation with 3D-reconstruction, J Cardiovasc Electrophysiol, 2014;25:1314–20.
12. Kuck KH, Fürnkranz A, Chun KR, et al. Cryoballoon or radiofrequency ablation for symptomatic paroxysmal atrial fibrillation: reintervention, rehospitalization, and quality-of-life outcomes in the FIRE AND ICE trial, Eur Heart J, 2016 Jul 5 [Epub ahead of print].
13. Camm AJ, Lip GY, De Caterina R, et al. 2012 fo- cused update of the ESC Guidelines for the management of atrial fibrillation: an up- date of the 2010 ESC Guidelines for the management of atrial fibrillation. Developed with the special contribution of the European Heart Rhythm Associ- ation. Europace 2012;14:1385–413.
14-Eikelboom JW, Wallentin L, Connolly SJ, Ezekowitz M, Healey JS, Oldgren J et al. Risk of bleeding with 2 doses of dabigatran compared with warfarin in older and younger patients with atrial fibrillation: an analysis of the rando- mized evaluation of long-term anticoagulant therapy (RE-LY) trial. Circulation 2011;123:2363 – 72.
15. Hylek EM, Evans-Molina C, Shea C, Henault LE, Regan S. Major hemorrhage and tolerability of warfarin in the first year of therapy among elderly patients with atrial fibrillation. Circulation 2007;115:2689–96.
16. Wallentin L, Yusuf S, Ezekowitz MD, Alings M, Flather M, Franzosi MG et al. Efficacy and safety of dabigatran compared with warfarin at different levels of international normalised ratio control for stroke prevention in atrial fibrillation: an analysis of the RE-LY trial. Lancet 2010;376:975–83.
17. Lip GY, Tse HF, Lane DA. Atrial fibrillation. Lancet. 2012; 379(9816):648-61.
18. Lip GY, Nieuwlaat R, Pisters R, Lane DA, et al: Refining Clinical Risk Stratification for prediction stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: The Euroheart Survey on atrial fibrillation. Chest 2010; 137(2):263-272
19. Lip GY, Frison L, Halperin JL, Lane DA; Identifying patients of high risk for stroke despite anticoagulation: a comparison of contemporary stroke risk stratification schemes in an anticoagulates atrial fibrillation cohort. Stroke 2010; 41(12):2731-8.
20. Lane DA, Lip GY. Use of the CHA(2)DS(2)-VASc and HAS-BLED scores to aid decision making for throm- boprophylaxis in nonvalvular atrial fibrillation. Circulation. 2012 Aug;126(7):860-5. DOI 10.1161/Circulation. AHA.111.060061.
21. Senoo K, Lip GY. Predictive abilities of the HAS-BLED and ORBIT bleeding risk scores in non-warfarin anticoagulated atrial fibrillation patients: An ancillary analysis from the AMADEUS trial. Int J Cardiol. 2016 Oct;221:379-82. DOI 10.1016/j.ijcard.2016.07.100.
22. O’Brien EC, Simon DN, Thomas LE, Hylek EM, Ger- sh BJ, Ansell JE, et al. The ORBIT bleeding score: a simple bedside score to assess bleeding risk in atrial fibrillation. Eur Heart J. 2015 Dec;36(46):3258-64. DOI 10.1093/eurheartj/ehv476.
23. Meier B, Blaauw Y,Khattab AA, Lewalter T, Sievert H,Tondo C et al.EHRA/EAPCI expert consensus statement on catheter-based left atrial appendage occlusion. Europace 2014;16:1397–416.
24. Lewalter T, Kanagaratnam P,Schmidt B,Rosenqvist M,Nielsen-Kudsk JE,Ibrahim R et al. Ischaemic stroke prevention in patients with atrial fibrillation and high bleeding risk: opportunities and challenges for percutaneous left atrial appendage occlusion. Europace 2014;16:626–30.
25. Fountain RB, Holmes DR, Chandrasekaran K, Packer D, Asirvatham S, Van Tassel TR et al. The PROTECT AF (WATCHMAN Left Atrial Appendage System for Embolic PROTECTion in Patients with Atrial Fibrillation) trial. Am Heart J 2006; 151:956 – 61.
26. Holmes DR, Reddy VY, Turi ZG, Doshi SK, Sievert H, Buchbinder M et al. Percu- taneous closure of the left atrial appendage versus warfarin therapy for prevention of stroke in patients with atrial fibrillation: a randomised non-inferiority trial. Lancet 2009;374:534 – 42.
27. Meier B, Blauw Y, Khattad AA, Lewalter T, Sievert H, Tondo C et al. EHRA/EAPCI expert consensus statement on catheter-based left atrial appendage occlusion. Europace 2014;16:1397–416.
28. Reddy VY, Holmes D, Doshi SK, Neuzil P and Kar S. Safety of percutaneous left atrial appendage closure: results from the Watchman Left Atrial Appendage System for Embolic Protection in Patients with AF (PROTECT AF) clinical trial and the Continued Access Registry. Circulation. 2011;123:417-24.
29. Holmes JDR, Kar S, Price MJ, Whisenant B, Sievert H, Doshi SK, Huber K and Reddy VY. Prospective Randomized Evaluation of the Watchman Left Atrial Appendage Closure Device in Patients With Atrial Fibrillation Versus Long-Term Warfarin TherapyThe PREVAIL Trial. Journal of the American College of Cardiology. 2014;64:1-12.
30. Steinberg JS, Palekar R, Sichrovsky T, Arshad A, Preminger M, Musat D et al. Very long-term outcome after initially successful catheter ablation of atrial fibril- lation. Heart Rhythm 2014;11:771–6.
31. Nyong J, Amit G, Adler AJ, Owolabi OO, Perel P, Prieto-Merino D et al. Efficacy and safety of ablation for people with non-paroxysmal atrial fibrillation. Cochrane Database Syst Rev 2016;11:CD012088.
32. Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Europace 2016;18:1609–78.
33. Turagam MK, Lavu M, Afzal MR, Vuddanda V, Jazayeri MA, Parikh V. Catheter Ablation for Atrial Fibrillation in Patients With Watchman Left Atrial Appendage Occlusion Device: Results from a Multicenter Registry. J Cardiovasc Electrophysiol. 2017 Feb;28(2):139-146. doi: 10.1111/jce.13148
34. Heeger CH, Rillig A, Lin T, Mathew S, Deiss S, Lemes C. Feasibility and clinical efficacy of left atrial ablation for the treatment of atrial tachyarrhythmias in patients with left atrial appendage closure devices . Heart Rhythm. 2015
Jul;12(7):1524-31. doi: 10.1016/j.hrthm.2015.03.011
35. Swaans MJ, Post MC, Rensing BJ, Boersma LV. Ablation for atrial fibrillation in combination with left atrial appendage closure: first results of a feasibility study.J Am Heart Assoc. 2012 Oct;1(5):e002212. doi: 10.1161/JAHA.112.002212.
36. Calvo N, Salterain N, Arguedas H, Macias A, Esteban A, García de Yébenes M. et al. Combined catheter ablation and left atrial appendage closure as a hybrid procedure for the treatment of atrial fibrillation. Europace. 2015 Oct;17(10):1533-40. doi: 10.1093/europace/euv070
37. Phillips KP, Pokushalov E, Romanov A, Artemenko S, Folkeringa RJ, Szili-Torok T. et al. Combining Watchman left atrial appendage closure and catheter ablation for atrial fibrillation: multicentre registry results of feasibility and safety during implant and 30 days follow-up. Europace. 2018 Jun 1;20(6):949-955. doi: 10.1093/europace/eux183.
38. Wintgens L, Romanov A, Phillips K, Ballesteros G, Swaans M, Folkeringa R. et al. Combined atrial fibrillation ablation and left atrial appendage closure: long-term follow-up from a large multicentre registry. Europace. 2018 Nov 1;20(11):1783-1789. doi: 10.1093/europace/euy025.
39. Fassini G, Conti S, Moltrasio M, Maltagliati A, Tundo F, Riva S. et al. Concomitant cryoballoon ablation and percutaneous closure of left atrial appendage in patients with atrial fibrillation. Europace. 2016 Nov;18(11):1705-1710.
40. Kuck, KH. Should LAAO be performed at the time of atrial fibrillation ablation? HRS Sessions. Boston. May 2018.
2. Go AS, Hylek EM, Phillips KA, Chang Y, Henault LE, Selby JV, Singer DE. Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. JAMA. 2001;285:2370–2375.
3. Stewart S, Hart CL, Hole DJ, McMurray JJ. Population prevalence, incidence, and predictors of atrial fibrillation in the Renfrew/Paisley study. Heart. 2001;86:516–521.
4. Lloyd-Jones DM, Wang TJ, Leip EP, Larson MG, Levy D, Vasan RS, et al. Lifetime risk for development of atrial fibrillation: the Framingham Heart Study. Circulation. 2004;110:1042–1046.
5. Blackshear JL, Odell JA. Appendage obliteration to reduce stroke in cardiac surgical patients with atrial fibrillation. Ann Thorac Surg. 1996;61:755–759.
6. Wazni OM, Marrouche NF, Martin DO, Verma A, Bhargava M, Saliba W et al. Radiofrequency ablation vs antiarrhythmic drugs as first-line treatment of symptomatic atrial fibrillation: a randomized trial. JAMA 2005;293: 2634 – 40.
7. Mohanty S, Mohanty P, Di Biase L, Bai R, Santangeli P, Casella M et al. Results from a single-blind, randomized study comparing the impact of different ablation ap- proaches on long-term procedure outcome in coexistent atrial fibrillation and flutter (APPROVAL). Circulation 2013;127:1853 – 60.
8. Calkins H, Kuck KH, Cappato R, et al. 2012 HRS/EHRA/ECAS expert consensus statement on catheter and surgical ablation of atrial fibrillation: recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial design: a report of the Heart Rhythm Society (HRS) Task Force on Catheter and Surgical Ablation of Atrial Fibrillation: developed
in partnership with the European Heart Rhythm Association (EHRA), a registered branch of the European Society of Cardiology (ESC) and the European Cardiac Arrhythmia Society (ECAS); and in collaboration with the American College of Cardiology (ACC), American Heart Association
(AHA), the Asia Pacific Heart Rhythm Society (APHRS), and the Society of Thoracic Surgeons (STS): endorsed by the governing bodies of the American College of Cardiology Foundation, the American Heart Association, the European Cardiac Arrhythmia Society, the European Heart Rhythm Association, the Society of Thoracic Surgeons, the Asia Pacific Heart Rhythm Society, and the Heart Rhythm Society. Heart
Rhythm 2012;9:632-696.e21
9. Haïssaguerre M, Jaïs P, Shah DC, et al. Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins. N Engl J Med 1998;339:659-666
10. Kuck KH, Brugada J, Fürnkranz A, et al. Cryoballoon or Radiofrequency Ablation for Paroxysmal Atrial Fibrillation, N Engl J Med, 2016;374:2235–45.
11. Fürnkranz A, Brugada J, Albenque JP, et al. Rationale and design of FIRE AND ICE: A multicenter randomized trial comparing efficacy and safety of pulmonary vein isolation using a cryoballoon versus radiofrequency ablation with 3D-reconstruction, J Cardiovasc Electrophysiol, 2014;25:1314–20.
12. Kuck KH, Fürnkranz A, Chun KR, et al. Cryoballoon or radiofrequency ablation for symptomatic paroxysmal atrial fibrillation: reintervention, rehospitalization, and quality-of-life outcomes in the FIRE AND ICE trial, Eur Heart J, 2016 Jul 5 [Epub ahead of print].
13. Camm AJ, Lip GY, De Caterina R, et al. 2012 fo- cused update of the ESC Guidelines for the management of atrial fibrillation: an up- date of the 2010 ESC Guidelines for the management of atrial fibrillation. Developed with the special contribution of the European Heart Rhythm Associ- ation. Europace 2012;14:1385–413.
14-Eikelboom JW, Wallentin L, Connolly SJ, Ezekowitz M, Healey JS, Oldgren J et al. Risk of bleeding with 2 doses of dabigatran compared with warfarin in older and younger patients with atrial fibrillation: an analysis of the rando- mized evaluation of long-term anticoagulant therapy (RE-LY) trial. Circulation 2011;123:2363 – 72.
15. Hylek EM, Evans-Molina C, Shea C, Henault LE, Regan S. Major hemorrhage and tolerability of warfarin in the first year of therapy among elderly patients with atrial fibrillation. Circulation 2007;115:2689–96.
16. Wallentin L, Yusuf S, Ezekowitz MD, Alings M, Flather M, Franzosi MG et al. Efficacy and safety of dabigatran compared with warfarin at different levels of international normalised ratio control for stroke prevention in atrial fibrillation: an analysis of the RE-LY trial. Lancet 2010;376:975–83.
17. Lip GY, Tse HF, Lane DA. Atrial fibrillation. Lancet. 2012; 379(9816):648-61.
18. Lip GY, Nieuwlaat R, Pisters R, Lane DA, et al: Refining Clinical Risk Stratification for prediction stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: The Euroheart Survey on atrial fibrillation. Chest 2010; 137(2):263-272
19. Lip GY, Frison L, Halperin JL, Lane DA; Identifying patients of high risk for stroke despite anticoagulation: a comparison of contemporary stroke risk stratification schemes in an anticoagulates atrial fibrillation cohort. Stroke 2010; 41(12):2731-8.
20. Lane DA, Lip GY. Use of the CHA(2)DS(2)-VASc and HAS-BLED scores to aid decision making for throm- boprophylaxis in nonvalvular atrial fibrillation. Circulation. 2012 Aug;126(7):860-5. DOI 10.1161/Circulation. AHA.111.060061.
21. Senoo K, Lip GY. Predictive abilities of the HAS-BLED and ORBIT bleeding risk scores in non-warfarin anticoagulated atrial fibrillation patients: An ancillary analysis from the AMADEUS trial. Int J Cardiol. 2016 Oct;221:379-82. DOI 10.1016/j.ijcard.2016.07.100.
22. O’Brien EC, Simon DN, Thomas LE, Hylek EM, Ger- sh BJ, Ansell JE, et al. The ORBIT bleeding score: a simple bedside score to assess bleeding risk in atrial fibrillation. Eur Heart J. 2015 Dec;36(46):3258-64. DOI 10.1093/eurheartj/ehv476.
23. Meier B, Blaauw Y,Khattab AA, Lewalter T, Sievert H,Tondo C et al.EHRA/EAPCI expert consensus statement on catheter-based left atrial appendage occlusion. Europace 2014;16:1397–416.
24. Lewalter T, Kanagaratnam P,Schmidt B,Rosenqvist M,Nielsen-Kudsk JE,Ibrahim R et al. Ischaemic stroke prevention in patients with atrial fibrillation and high bleeding risk: opportunities and challenges for percutaneous left atrial appendage occlusion. Europace 2014;16:626–30.
25. Fountain RB, Holmes DR, Chandrasekaran K, Packer D, Asirvatham S, Van Tassel TR et al. The PROTECT AF (WATCHMAN Left Atrial Appendage System for Embolic PROTECTion in Patients with Atrial Fibrillation) trial. Am Heart J 2006; 151:956 – 61.
26. Holmes DR, Reddy VY, Turi ZG, Doshi SK, Sievert H, Buchbinder M et al. Percu- taneous closure of the left atrial appendage versus warfarin therapy for prevention of stroke in patients with atrial fibrillation: a randomised non-inferiority trial. Lancet 2009;374:534 – 42.
27. Meier B, Blauw Y, Khattad AA, Lewalter T, Sievert H, Tondo C et al. EHRA/EAPCI expert consensus statement on catheter-based left atrial appendage occlusion. Europace 2014;16:1397–416.
28. Reddy VY, Holmes D, Doshi SK, Neuzil P and Kar S. Safety of percutaneous left atrial appendage closure: results from the Watchman Left Atrial Appendage System for Embolic Protection in Patients with AF (PROTECT AF) clinical trial and the Continued Access Registry. Circulation. 2011;123:417-24.
29. Holmes JDR, Kar S, Price MJ, Whisenant B, Sievert H, Doshi SK, Huber K and Reddy VY. Prospective Randomized Evaluation of the Watchman Left Atrial Appendage Closure Device in Patients With Atrial Fibrillation Versus Long-Term Warfarin TherapyThe PREVAIL Trial. Journal of the American College of Cardiology. 2014;64:1-12.
30. Steinberg JS, Palekar R, Sichrovsky T, Arshad A, Preminger M, Musat D et al. Very long-term outcome after initially successful catheter ablation of atrial fibril- lation. Heart Rhythm 2014;11:771–6.
31. Nyong J, Amit G, Adler AJ, Owolabi OO, Perel P, Prieto-Merino D et al. Efficacy and safety of ablation for people with non-paroxysmal atrial fibrillation. Cochrane Database Syst Rev 2016;11:CD012088.
32. Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Europace 2016;18:1609–78.
33. Turagam MK, Lavu M, Afzal MR, Vuddanda V, Jazayeri MA, Parikh V. Catheter Ablation for Atrial Fibrillation in Patients With Watchman Left Atrial Appendage Occlusion Device: Results from a Multicenter Registry. J Cardiovasc Electrophysiol. 2017 Feb;28(2):139-146. doi: 10.1111/jce.13148
34. Heeger CH, Rillig A, Lin T, Mathew S, Deiss S, Lemes C. Feasibility and clinical efficacy of left atrial ablation for the treatment of atrial tachyarrhythmias in patients with left atrial appendage closure devices . Heart Rhythm. 2015
Jul;12(7):1524-31. doi: 10.1016/j.hrthm.2015.03.011
35. Swaans MJ, Post MC, Rensing BJ, Boersma LV. Ablation for atrial fibrillation in combination with left atrial appendage closure: first results of a feasibility study.J Am Heart Assoc. 2012 Oct;1(5):e002212. doi: 10.1161/JAHA.112.002212.
36. Calvo N, Salterain N, Arguedas H, Macias A, Esteban A, García de Yébenes M. et al. Combined catheter ablation and left atrial appendage closure as a hybrid procedure for the treatment of atrial fibrillation. Europace. 2015 Oct;17(10):1533-40. doi: 10.1093/europace/euv070
37. Phillips KP, Pokushalov E, Romanov A, Artemenko S, Folkeringa RJ, Szili-Torok T. et al. Combining Watchman left atrial appendage closure and catheter ablation for atrial fibrillation: multicentre registry results of feasibility and safety during implant and 30 days follow-up. Europace. 2018 Jun 1;20(6):949-955. doi: 10.1093/europace/eux183.
38. Wintgens L, Romanov A, Phillips K, Ballesteros G, Swaans M, Folkeringa R. et al. Combined atrial fibrillation ablation and left atrial appendage closure: long-term follow-up from a large multicentre registry. Europace. 2018 Nov 1;20(11):1783-1789. doi: 10.1093/europace/euy025.
39. Fassini G, Conti S, Moltrasio M, Maltagliati A, Tundo F, Riva S. et al. Concomitant cryoballoon ablation and percutaneous closure of left atrial appendage in patients with atrial fibrillation. Europace. 2016 Nov;18(11):1705-1710.
40. Kuck, KH. Should LAAO be performed at the time of atrial fibrillation ablation? HRS Sessions. Boston. May 2018.
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Published
2018-10-01
How to Cite
Arabia, L. A. (2018). Hybrid percutaneous treatment of atrial fibrillation: Ablation and occlusion of the left atrial appendage. State of the art. JOURNAL OF CARDIAC ARRHYTHMIAS, 31(4), 183–188. Retrieved from https://jca.emnuvens.com.br/jca/article/view/105
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