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.