Percutaneous Epicardial Left Atrial Appendage Closure: Preliminary Results of an Electrogram Guided Approach

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dc.contributor.author Friedman, Paul A.
dc.contributor.author Asirvatham, Samuel J.
dc.contributor.author Dalegrave, Charles [UNIFESP]
dc.contributor.author Kinoshita, Masayoshi
dc.contributor.author Danielsen, Andrew J.
dc.contributor.author Johnson, Susan B.
dc.contributor.author Hodge, David O.
dc.contributor.author Munger, Thomas M.
dc.contributor.author Packer, Douglas L.
dc.contributor.author Bruce, Charles J.
dc.date.accessioned 2016-01-24T13:58:37Z
dc.date.available 2016-01-24T13:58:37Z
dc.date.issued 2009-08-01
dc.identifier http://dx.doi.org/10.1111/j.1540-8167.2009.01465.x
dc.identifier.citation Journal of Cardiovascular Electrophysiology. Malden: Wiley-Blackwell Publishing, Inc, v. 20, n. 8, p. 908-915, 2009.
dc.identifier.issn 1045-3873
dc.identifier.uri http://repositorio.unifesp.br/handle/11600/31737
dc.description.abstract Background: Pharmacologic therapies to prevent stroke in atrial fibrillation (AF) have numerous limitations, prompting the development of device-based therapies. We investigated whether an electrogram-based approach using a novel hollow suture can safely capture and ligate the left atrial appendage (LAA).Methods and Results: A novel system for closure of the LAA within the confines of the closed pericardium with a single sheath puncture was tested in 4 dogs. the tool used to grasp the appendage was fitted with electrodes and utilized electrical navigation to identify and confirm LAA capture. A hollow suture preloaded with a mechanical support wire to permit its manipulation and fluoroscopic visualization was advanced over the grasper, and the wire removed after the suture was positioned. the LAA was successfully closed in all dogs. in 2 dogs, after closure, a thoracotomy was performed and the LAA amputated without bleeding, confirming closure integrity. Necropsy confirmed closure in all animals.Conclusions: Using electrical navigation, percutaneous epicardial LAA ligation with a remotely tightened suture was performed successfully within the confines of the intact pericardial space. This technique may allow decreasing the risk of stroke in AF patients without the need for thoracotomy or an endocardially placed prosthetic device.(J Cardiovasc Electrophysiol, Vol. 20, pp. 908-915, August 2009). en
dc.description.sponsorship Aegis Medical (Vancouver, Canada)
dc.description.sponsorship Mayo Discovery Translation Award
dc.format.extent 908-915
dc.language.iso eng
dc.publisher Wiley-Blackwell
dc.relation.ispartof Journal of Cardiovascular Electrophysiology
dc.rights Acesso restrito
dc.subject left atrial appendage en
dc.subject atrial fibrillation en
dc.subject stroke en
dc.subject epicardial en
dc.subject electrograms en
dc.title Percutaneous Epicardial Left Atrial Appendage Closure: Preliminary Results of an Electrogram Guided Approach en
dc.type Artigo
dc.rights.license http://olabout.wiley.com/WileyCDA/Section/id-406071.html
dc.contributor.institution Mayo Clin
dc.contributor.institution Universidade Federal de São Paulo (UNIFESP)
dc.contributor.institution Mayo Clin Hlth Solut
dc.description.affiliation Mayo Clin, Dept Internal Med, Div Cardiovasc Dis, Rochester, MN 55905 USA
dc.description.affiliation Mayo Clin, Dept Pediat Cardiol, Div Pediat & Adolescent Med, Rochester, MN 55905 USA
dc.description.affiliation Universidade Federal de São Paulo, São Paulo Hosp, São Paulo, Brazil
dc.description.affiliation Mayo Clin Hlth Solut, Rochester, MN USA
dc.description.affiliation Mayo Clin, Dept Hlth Sci Res, Div Biomed Stat & Informat, Rochester, MN 55905 USA
dc.description.affiliationUnifesp Universidade Federal de São Paulo, São Paulo Hosp, São Paulo, Brazil
dc.identifier.doi 10.1111/j.1540-8167.2009.01465.x
dc.description.source Web of Science
dc.identifier.wos WOS:000268457600013



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