What is the clinical evidence from this study?

Study design: Observational. Population: Atrial fibrillation (n=178). Intervention: Combined catheter ablation and left atrial appendage closure (LAAC). Primary outcome: Immediate ablation success rate.

What question did this study set out to answer?

This study aimed to evaluate the feasibility and safety of performing catheter ablation and left atrial appendage closure in a single procedure for atrial fibrillation.

May 18, 2020Chinese Medical JournalOpen Access

One-stop strategy for treatment of atrial fibrillation: feasibility and safety of combining catheter ablation and left atrial appendage closure in a single procedure

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Key result

Single-procedure catheter ablation and LAAC achieves ~99% immediate success with satisfactory seal in AF.

n=178

Why the study?

Catheter ablation restores sinus rhythm and LAAC prevents stroke in AF, but the feasibility and safety of combining both into a single procedure required evaluation.

Is a combined catheter ablation and left atrial appendage closure procedure feasible and safe in patients with non-valvular atrial fibrillation?

Key Points

This study aimed to evaluate the feasibility and safety of performing catheter ablation and left atrial appendage closure in a single procedure for atrial fibrillation.
178 consecutive atrial fibrillation patients underwent combined catheter ablation and LAAC with the WATCHMAN device.
Pre-procedural evaluations included assessment of baseline parameters and intra-procedural monitoring.
Patients were followed up at three months and one year post-procedure.
Immediate ablation success rate was 98.9% with pulmonary vein isolation achieved in all patients.
At 3-month follow-up, sinus rhythm was maintained in 86.0% (153/178) of patients and device-related issues were absent.
During a one-year follow-up, 72.2% (52/72) of earlier enrolled patients maintained sinus rhythm without any observed stroke or systemic embolism.

Study Design

Type

Observational (n=178)

Structured PICO

Is a combined catheter ablation and left atrial appendage closure procedure feasible and safe in patients with non-valvular atrial fibrillation?

Population

178 consecutive Chinese adults (aged 18-85 years) with symptomatic drug-refractory paroxysmal or persistent atrial fibrillation, with contraindications or unwillingness to receive long-term oral anticoagulants. Mean age 68.9 ± 8.1 years, 52.8% male. Mean CHA2DS2-VASc score 3.3 ± 1.5, HAS-BLED score 1.6 ± 1.0. Excluded patients with severe valvular heart diseases and hyperthyroidism.

Intervention

Combined (one-stop) procedure of catheter ablation (standard pulmonary vein isolation with additional linear ablation if deemed necessary) and left atrial appendage closure (LAAC) using the WATCHMAN device in a single procedure.

Outcome

Feasibility (immediate ablation success and satisfactory seal) and safety (peri-operative complications including stroke, cardiac perforation, bleeding, and death) at 3 months and 1 year follow-up.safety

Limitations

Only WATCHMAN device was used, limiting generalizability to other LAAC devices
Single center observational study design
No direct comparison or control group for separated approaches of AF ablation and LAAC
Long-term outcomes require further investigation

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

Single-session ablation plus LAAC appears feasible in AF; leaves open efficacy and safety confirmation in randomized trials.

Cite This Study

Chen et al. (2020) conducted an observational in Atrial fibrillation (n=178). Combined catheter ablation and left atrial appendage closure (LAAC) was evaluated on Immediate ablation success rate. Combining catheter ablation and left atrial appendage closure in a single procedure achieved a 98.9% immediate ablation success rate and 100% satisfactory seal in patients with atrial fibrillation.

synapsesocial.com/papers/6a0663543f8bf83a443dda86 https://doi.org/10.1097/cm9.0000000000000855

Topics

Left atrial appendage closure Atrial fibrillation Persistent AF management AF ablation outcomes Anticoagulation in AF

View Full Paper

Ask AI

Bookmark

One-stop strategy for treatment of atrial fibrillation: feasibility and safety of combining catheter ablation and left atrial appendage closure in a single procedure

Key Points

Study Design

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Topics

One-stop strategy for treatment of atrial fibrillation: feasibility and safety of combining catheter ablation and left atrial appendage closure in a single procedure

Key Points

Study Design

Structured PICO

Limitations

Discussion

Implication

Cite This Study

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