Search results for "Left atrial"
showing 10 items of 26 documents
Percutaneous closure of left atrial appendage to prevent embolic events in high-risk patients with chronic atrial fibrillation
2009
Background: Percutaneous closure of the left atrial appendage (LAA) is a novel alternative for the treatment of patients with atrial fibrillation (AF) and with a high risk of stroke who are not eligible for long-term anticoagulation therapy. The aim of this study was to asses the safety, feasibility, and long-term efficacy of this procedure. Methods: From July 2004 to June 2007, 20 patients (13 male, mean age 69 ± 8 years) with non–valvular AF (NV-AF) underwent LAA percutaneous closure using the PLAATO™ system, implanted through a transeptal access. All patients had contraindications to anticoagulant therapy and were at high risk for cardioembolic stroke (mean CHADS2 score 3 ± 1.2). A trans…
Exercising recommendations for paroxysmal AF in young and middle-aged athletes (PAFIYAMA) syndrome.
2017
We have recently described a new syndrome: strenuous endurance exercise-related atrial fibrillation (AF) under the acronym of ‘paroxysmal AF in young and middle-aged athletes’ (‘PAFIYAMA’). Provided that other risk factors for AF and underlying conditions have been excluded (1), the diagnostic criteria for this syndrome entail a number of conditions, classified as major and minor. An enhanced risk of AF has been clearly documented in endurance athletes (top-class, elite and recreational) (2-5), and such risk typically ranges between 1.2- to 15-fold compared to the general, sedentary population (the better cardiovascular fitness, the higher incidence of AF) (6-11). Anecdotally, the last auth…
The Role of Patient-Specific Morphological Features of the Left Atrial Appendage on the Thromboembolic Risk Under Atrial Fibrillation
2022
BackgroundA large majority of thrombi causing ischemic complications under atrial fibrillation (AF) originate in the left atrial appendage (LAA), an anatomical structure departing from the left atrium, characterized by a large morphological variability between individuals. This work analyses the hemodynamics simulated for different patient-specific models of LAA by means of computational fluid–structure interaction studies, modeling the effect of the changes in contractility and shape resulting from AF.MethodsThree operating conditions were analyzed: sinus rhythm, acute atrial fibrillation, and chronic atrial fibrillation. These were simulated on four patient-specific LAA morphologies, each…
Speckle tracking analysis: a new tool for left atrial function analysis in systemic hypertension: an overview
2014
Speckle tracking echocardiography (STE) is an imaging technique applied to the analysis of left atrial function. STE provides a non-Doppler, angle-independent and objective quantification of left atrial myocardial deformation. Data regarding feasibility, accuracy and clinical applications of left atrial strain are rapidly gathering. This review describes the fundamental concepts of left atrial STE, illustrates its pathophysiological background and discusses its emerging role in systemic arterial hypertension.
Left Atrial Remodeling and Brain Natriuretic Peptide Levels Variation after Left Atrial Appendage Occlusion
2021
Background: Few data are available about brain natriuretic peptide (BNP) variation and left atrial remodeling after the left atrial appendage occlusion (LAAO) technique. Methods: Prospective study included all consecutive patients successfully implanted with an LAAO device. Contrast-enhanced cardiac computed tomography (CT) was performed before and 6 weeks after the procedure with reverse left atrial remodeling defined by an increase in LA volume >
The role of patient specific morphology and contractility of the left atrial appendage on the thromboembolic risk in atrial fibrillation
2022
The vast majority of thrombi that cause ischemic complications in atrial fibrillation originate in the left atrial appendage. The left atrial appendage is an anatomical structure that starts from the left atrium, characterized by a wide morphological variability between individuals. This work analyses simulated hemodynamic for different patient-specific models of the left atrial appendage, using computational fluid-structure interaction studies, modelling the effect of changes in contractility and shape resulting from atrial fibrillation. Three operating conditions were analysed: sinus rhythm, acute atrial fibrillation, and chronic atrial fibrillation. These were simulated on four patient-s…
Analysis of in-silico body surface P-wave integral maps show important differences depending on the connections between coronary sinus and left atrium
2016
The electrical connections between the atrial coronary sinus (CS) and the left atrial (LA) myocardium have an effect on the overall atrial activation pattern and the P-wave morphology. In this study, we use our validated multi-scale 3D human atrial-torso model to elucidate which electro-anatomical configuration of connections between CS and LA more accurately reproduces a set of body surface P-wave integral maps (BSPiM) acquired in the clinic. We performed atrial biophysical simulations by pacing in distal and proximal LA sites. The corresponding in-silico BSPiM were then computed and compared with published clinical patterns obtained from patients. Important differences in BSPiM were obser…
Amulet or Watchman Device for Percutaneous Left Atrial Appendage Closure: Primary Results of the SWISS-APERO Randomized Clinical Trial.
2022
Background:No study has so far compared Amulet with the new Watchman FLX in terms of residual left atrial appendage (LAA) patency or clinical outcomes in patients undergoing percutaneous LAA closure.Methods:In the investigator-initiated SWISS APERO trial (Comparison of Amulet Versus Watchman/FLX Device in Patients Undergoing Left Atrial Appendage Closure), patients undergoing LAA closure were randomly assigned (1:1) open label to receive Amulet or Watchman 2.5 or FLX (Watchman) across 8 European centers. The primary end point was the composite of justified crossover to a nonrandomized device during LAA closure procedure or residual LAA patency detected by cardiac computed tomography angiogr…
0283: Correlation between N-terminal pro-natriuretic peptide levels and left atrial size in patients with left ventricular systolic dysfunction
2014
BackgroundElevated N-terminal Pro B-type Natriuretic Peptide (NT Pro-BNP) levels are correlated with the severity of left ventricular systolic dysfunction and left ventricular filling alterations. Besides, left atrial (LA) size is believed to reflect chronic diastolic dysfunction.AimEvaluate the relationship between NT Pro-BNP and LA size.Methods81 patients (77.7% males; mean age, 61.55±15 years), with left ventricular systolic dysfunction (left ventricular ejection fraction [LVEF] 20cm2 was 1188pg/mL (area under the receiver-operating characteristic curve [AUC] 0.83 [0.71–0.93], p<0.0001, sensitivity 77.6%, specificity 75%).ConclusionThe present study shows that plasma NT Pro-BNP levels is…
Effect of the Alterations in Contractility and Morphology Produced by Atrial Fibrillation on the Thrombosis Potential of the Left Atrial Appendage
2021
Atrial fibrillation (AF) is a common arrhythmia mainly affecting the elderly population, which can lead to serious complications such as stroke, ischaemic attack and vascular dementia. These problems are caused by thrombi which mostly originate in the left atrial appendage (LAA), a small muscular sac protruding from left atrium. The abnormal heart rhythm associated with AF results in alterations in the heart muscle contractions and in some reshaping of the cardiac chambers. This study aims to verify if and how these physiological changes can establish hemodynamic conditions in the LAA promoting thrombus formation, by means of computational fluid dynamic (CFD) analyses. In particular, sinus …