Key result
LARIAT epicardial suture ligation successfully achieved electrical isolation of the left atrial appendage and terminated recurrent atrial tachycardia, with the patient remaining AT-free at 18 months.
Why the study?
Does Lariat epicardial suture ligation terminate recurrent left atrial tachycardia originating from the left atrial appendage?
Case Report (n=1)
No
Does Lariat epicardial suture ligation terminate recurrent left atrial tachycardia originating from the left atrial appendage?
Lariat epicardial suture ligation can successfully achieve electrical isolation and terminate recurrent left atrial tachycardia originating from the left atrial appendage.
Supports LARIAT feasibility for LAA-origin AT; hypothesis-generating, prospective trials needed before wider use.
Left atrial appendage (LAA) is a known trigger for left atrial tachycardia (AT). The use of LARIAT epicardial suture for termination of AT arising from LAA is not yet reported. A 66-year-old female had a history of hypertension, diabetes, sick sinus syndrome, labile INR, and symptomatic persistent AF. She underwent radiofrequency ablation after failed cardioversion and multiple antiarrhythmics. She was in AT originating from LAA on activation map. Radiofrequency endocardial LAA isolation was performed. However, the AT recurred with increased burden and symptoms. Due to her multiple hospitalization for spontaneous bleeds and labile INR, a Lariat epicardial suture ligation of her LAA was performed. With application of the Lariat suture, electrical isolation was achieved and the AT terminated. She remained AT free at 18 months. Our case is the first to illustrate the utility of LARIAT suture in electrical isolation of the LAA in addition to its mechanical exclusion.
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Atoui et al. (2015) conducted a case report in Left atrial tachycardia originating from the left atrial appendage (n=1). LARIAT epicardial suture ligation was evaluated on Electrical isolation and termination of atrial tachycardia. LARIAT epicardial suture ligation successfully achieved electrical isolation of the left atrial appendage and terminated recurrent atrial tachycardia, with the patient remaining AT-free at 18 months.
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