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The Role of the Left Atrial Appendage in Stroke and Arrhythmia Provocation

  • Alefiyah Rajabali
  • Nitish Badhwar
  • Randall J. Lee
Arrhythmias (J. Bunch, Section Editor)
  • 74 Downloads
Part of the following topical collections:
  1. Topical Collection on Arrythmias

Abstract

Purpose of the review

The review will provide an overview of the potential use of left atrial appendage (LAA) exclusion in patients with atrial fibrillation (AF), highlighting the benefits and risks involved with LAA exclusion.

Recent findings

LAA ligation leads to electrical isolation of the LAA and a decrease in LA mass which is associated with a decrease in AF burden and occasional termination of AF in patients with persistent AF. This potential new indication will further expand the use of LAA exclusion and necessitate planning of combining LAA exclusion with catheter ablation for both stroke prevention and antiarrhythmic benefits. Operator experience and training leads to lower adverse events rendering LAA occlusion a safe and effective strategy for stroke reduction in a carefully selected patient population.

Summary

Widespread use of the LAA occlusion devices is limited by the need for adequate technical training and operator learning curve, risk of complications, and lack of direct comparative data with novel anticoagulants. LAA closure as an adjunct to pulmonary vein isolation may expand upon the use of current closure devices.

Keywords

Atrial fibrillation WATCHMAN LARIAT AtriClip Stroke LAA 

Notes

Compliance with Ethical Standards

Conflict of Interest

Alefiyah Rajabali and Nitish Badhwar declare that they have no conflict of interest.

Randall J. Lee is a consultant and equity holder of SentreHEART, Inc.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Alefiyah Rajabali
    • 1
  • Nitish Badhwar
    • 1
  • Randall J. Lee
    • 1
  1. 1.Section of Cardiac Electrophysiology, Division of Cardiology, Department of MedicineUniversity of California, San FranciscoSan FranciscoUSA

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