Left Atrial Appendage Closure

The left atrial appendage (LAA) of the heart is a common location where clots form in atrial fibrillation (AFib) patients that then embolism and cause a stroke. Closing off the LAA either surgically, with a clip or via transcatheter LAA closure device, closes the opening to the LAA to prevent clots from forming or embolizing. The clots are the reason why AFib patients need to be on anticoagulants. LAA occlusion (LAAO) enables patients to stop taking anticoagulation drugs. LAAO has been a rapidly growing segment of structural heart procedures since the approval of the first device, the Watchman, in 2015. Procedures are performed by electrophysiologists, interventional cardiologist or cardiac surgeons.

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MRI-guided EP lab ablation procedure using mapping and MRI-safe catheters from Imricor, displayed at HRS 2023. Photo by Dave Fornell

PHOTO GALLERY: Electrophysiology advances at Heart Rhythm 2023

Heart Rhythm 2023 in New Orleans brought together EP experts from all over the world. Scroll through a large selection of photos from the big event. 

June 2, 2023
Images from the consensus document showing the proper left atrial appendage (LAA) sizing assessment for a transcatheter occluder device using transesophageal echo (TEE). Sizing and evaluation for pre-existing thrombus in the LAA also can be performed using cardiac CT.

SCAI and HRS release expert consensus on transcatheter left atrial appendage occlusion

One of the new recommendations is to conduct baseline imaging with TEE or cardiac CT.

March 24, 2023
Example of an FFR-angio image-derived hemodynamic flow model performed tableside in the cath lab reconstructed using three different C-arm contract image acquisitions. This technology from CathWorks, which was recently acquired by Medtronic, can eliminate the need for pressure wires and adenosine to assess FFR pressures. These measurements are used to determine the hemodynamic significance of a stenosis and determine if a stent is necessary or if a patient can be treated medically.

PHOTO GALLERY: ACC.23 in New Orleans

Browse a selection of photos from the American College of Cardiology's annual meeting in New Orleans. The pictures highlight key moments, new technologies and much more from the big show. 

March 20, 2023
A 3D intracardiac echo (ICE) view of a surgical mitral valve using the NuVision ultrasound catheter developed by Biosense Webster in partnership with GE Healthcare.

Can intracardiac echo replace TEE during structural heart procedures?

TEE has been used to guide most transcatheter structural heart cases over the past decade, but 3D ICE is changing how some centers image those patients. 

February 10, 2023
Illustration of a left atrial appendage occlusion (LAAO) procedure using a Watchman device. Image courtesy of Johns Hopkins Medicine. #LAA #LAAO

Most devices implanted during LAAO procedures are oversized—and patients benefit

Oversized devices are becoming more common as time goes on, which suggests operators are growing increasingly comfortable with this treatment choice.

December 6, 2022
In-hospital complications are more common among women who undergo LAAO than men. However, according to a new study in JACC: Cardiovascular Interventions, men and women have similar long-term outcomes.

LAAO equally effective for men and women, new long-term study confirms

In-hospital complications are more common among women who undergo LAAO than men. However, according to a new study in JACC: Cardiovascular Interventions, men and women have similar long-term outcomes.

October 21, 2022
CT has been used for planning and procedural guidance in pulmonary vein isolation (PVI) for about 20 years. It shows the anatomy to the electrophysiologist. The EPs also can load the imaging into their EP mapping system. It also shows them the location of the esophagus and the phrenic nerve so they can avoid these during the procedures. #PVI #EPeeps

VIDEO: The expanding role of cardiac CT in electrophysiology

Harold Litt, MD, division chief of cardiothoracic imaging and director of the Center for Advanced CT Imaging Sciences at the Perelman School of Medicine of the University of Pennsylvania, explains the role of cardiac CT in EP procedures.

October 12, 2022
A FEOPS image of a Watchman LAA occluder device being checked for virtual sizing in an anatomical model of the patient's left atrial appendage. Dhanunjaya Lakkireddy, MD, explains the role and technology of LAA closure devices in managing AFib patients.

VIDEO: The value of left atrial appendage occlusion in AFib patients

Dhanunjaya Lakkireddy, MD, executive medical director for the Kansas City Heart Rhythm Institute at HCA Midwest Health, explains recent trials in left atrial appendage occlusion (LAAO) and how the therapy helps atrial fibrillation (AFib) patients. 

October 7, 2022
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