Introduction
Transcatheter left atrial appendage closure (LAAC) has emerged as a reasonable alternative to long-term oral anticoagulant therapy (OAT) for stroke prevention in patients with non-valvular atrial fibrillation (NVAF). Randomized trials for the Watchman device1-3and large, all-comer registries for Amplatzer devices4,5 have shown promising clinical outcomes in preventing stroke and avoiding bleeding events. Additionally, combined catheter ablation, including radiofrequency ablation and cryoablation with LAAC using Watchman or Amplatzer devices in a single procedure, were reported to be effective and safe strategies in patients who had indications for atrial fibrillation (AF) ablation and LAAC6-9.
The LAmbreTM occluder was recently introduced to clinical practice and small registry studies have shown high success rates for implantation and acceptable periprocedural complication rates10-12. Data of a combined procedure with the LAmbre device are still lacking. Different to Amplatzer devices, the umbrella of the LAmbre device has a double stabilization design with eight small distal hooks that engage into the wall of the left atrial appendage (LAA) and eight U-shaped ends trapping in LAA trabeculations (Figure 1). Previous studies11,13 showed that delayed cardiac effusion/cardiac tamponade (PE/PT) events might occur following LAAC with the LAmbre device.
We retrospectively investigated the safety and short-term outcome in patients who underwent isolated LAAC with the LAmbre device or combined treatment of catheter ablation for AF and LAAC. A modified method (MM) for LAmbre device implantation was compared with the conventional method (CM) in this study.