Key result
Catheter ablation plus LAAC linked to ~119% more residual leaks vs LAAC alone.
Why the study?
Catheter ablation of AF may cause ridge edema, which could affect the safety of left atrial appendage closure.
Does combining catheter ablation with left atrial appendage closure affect residual leaks and device compression in patients with atrial fibrillation?
Cohort (n=98)
No
Does combining catheter ablation with left atrial appendage closure affect residual leaks and device compression in patients with atrial fibrillation?
Absolute Event Rate: 37.3% vs 17%
p-value: p=0.04
Combining catheter ablation with LAAC is feasible and safe but may lead to increased residual leaks and reduced device compression due to the resolution of ablation-induced ridge edema.
May increase residual leaks with combined ablation-LAAC; leaves open effects on long-term embolic risk.
Objectives: To compare patients with atrial fibrillation (AF) undergoing left atrial appendage closure (LAAC) with catheter ablation (CA) and those without CA. Background: The CA of AF may cause ridge edema, which may affect the safety of LAAC. Methods: = 47) received pre-procedural, intra-procedural, and 6 week post-procedural transesophageal echocardiography (TEE). The depth and ostial diameter of LAA, device compression, residual leak, and ridge thickness were evaluated in the patients who had undergone combined and alone procedures, as well as images of LAA and primary clinical characteristics. There was no significant difference between both groups in all-cause mortality, cardiovascular mortality, and TIA/stroke/system embolism. Conclusion: The combined procedures of CA and LAAC for AF are feasible and safe; however, during the follow-up period, we found that the resolution of ridge edema caused by CA might cause an increased residual leak and a smaller device compression ratio.
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Zhu et al. (2023) conducted a cohort in Atrial fibrillation (n=98). Catheter ablation combined with left atrial appendage closure vs. Left atrial appendage closure alone was evaluated on Residual leak at 6 weeks (p=0.04). The combined procedure of catheter ablation and left atrial appendage closure significantly increased the rate of residual leaks at 6 weeks compared to LAAC alone (37.3% vs. 17.0%, p=0.04).
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