Document Detail

Epicardial left atrial appendage clip occlusion also provides the electrical isolation of the left atrial appendage.
MedLine Citation:
PMID:  22647971     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: The exclusion of the left atrial appendage (LAA) has been used to reduce the risk of stroke associated with atrial fibrillation (AF). While LAA exclusion has been associated with a reduced risk of stroke, the effect on the electrical activity of the LAA (a potential source of AF) remains unknown. As such, we sought to demonstrate whether surgical epicardial clip occlusion leads to the electrical isolation of the LAA.
METHODS: From December 2010 until August 2011, 10 patients with paroxysmal AF underwent off-pump coronary artery bypass surgery with bilateral pulmonary vein isolation and an LAA clip occlusion with a new epicardial clip. Before and after the clip was placed, pacing manoeuvres were performed to assess the electrical exit and entry blocks from the LAA.
RESULTS: All clips were applied successfully. The mean procedure time for the clip application was 4 ± 1 min. No complications occurred related to clip application. Prior to the pericardial closure, 18 ± 3 min after the clip placement, the LAA stimulation and pacing manoeuvres demonstrated complete electrical isolation of the LAA in all cases.
CONCLUSIONS: Epicardial LAA clip occlusion leads to the acute electrical isolation of the LAA and may not only provide stroke prevention but also reduce the recurrence of AF.
Christoph T Starck; Jan Steffel; Maximilian Y Emmert; Andre Plass; Srijoy Mahapatra; Volkmar Falk; Sacha P Salzberg
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2012-05-30
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  15     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-08-21     Completed Date:  2013-01-17     Revised Date:  2013-09-03    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  416-8     Citation Subset:  IM    
Department of Cardiovascular Surgery, University Hospital Zurich, Zurich, Switzerland.
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MeSH Terms
Atrial Appendage / surgery*
Atrial Fibrillation / complications,  surgery*
Catheter Ablation / instrumentation*
Coronary Artery Bypass, Off-Pump / instrumentation*
Electric Injuries / prevention & control*
Follow-Up Studies
Pericardium / surgery*
Prostheses and Implants*
Retrospective Studies
Risk Factors
Stroke / epidemiology,  etiology,  prevention & control
Treatment Outcome
Comment In:
Interact Cardiovasc Thorac Surg. 2012 Sep;15(3):419   [PMID:  22908180 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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