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Erschienen in: Herzschrittmachertherapie + Elektrophysiologie 4/2017

25.10.2017 | Vorhofflimmern | Schwerpunkt

Aktuelle Indikationsstellung zur Vorhofohrokkluderimplantation

verfasst von: Clemens Jilek, PD Dr., Thorsten Lewalter, Prof. Dr. med.

Erschienen in: Herzschrittmachertherapie + Elektrophysiologie | Ausgabe 4/2017

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Zusammenfassung

Das Blutungsrisiko steigt mit dem Schlaganfallrisiko bei Patienten mit Vorhofflimmern. Okkluder des linken Vorhofohrs (LAA) erlauben, die Blutungsrate bei Risikopatienten zu senken. Ausgehend von einer Datenanalyse und des Konsensus-Dokuments der European Heart Rhythm Association (EHRA) werden die Indikationen für einen LAA-Okkluder beleuchtet und in einem klaren Schema für den klinischen Alltag präsentiert.
Literatur
2.
Zurück zum Zitat Grau AJ, Weimar C, Buggle F et al (2001) Risk factors, outcome, and treatment in subtypes of ischemic stroke: the German stroke data bank. Stroke 32:2559–2566CrossRefPubMed Grau AJ, Weimar C, Buggle F et al (2001) Risk factors, outcome, and treatment in subtypes of ischemic stroke: the German stroke data bank. Stroke 32:2559–2566CrossRefPubMed
3.
Zurück zum Zitat Jickling GC, Stamova B, Ander BP et al (2012) Prediction of cardioembolic, arterial, and lacunar causes of cryptogenic stroke by gene expression and infarct location. Stroke 43:2036–2041CrossRefPubMedPubMedCentral Jickling GC, Stamova B, Ander BP et al (2012) Prediction of cardioembolic, arterial, and lacunar causes of cryptogenic stroke by gene expression and infarct location. Stroke 43:2036–2041CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat Lin HJ, Wolf PA, Kelly-Hayes M, Beiser AS, Kase CS, Benjamin EJ, D’Agostino RB (1996) Stroke severity in atrial fibrillation. The Framingham Study. Stroke 27:1760–1764CrossRefPubMed Lin HJ, Wolf PA, Kelly-Hayes M, Beiser AS, Kase CS, Benjamin EJ, D’Agostino RB (1996) Stroke severity in atrial fibrillation. The Framingham Study. Stroke 27:1760–1764CrossRefPubMed
5.
Zurück zum Zitat Tu HT, Campbell BC, Christensen S, Collins M, De Silva DA, Butcher KS, Parsons MW, Desmond PM, Barber PA, Levi CR, Bladin CF, Donnan GA, Davis SM (2010) Pathophysiological determinants of worse stroke outcome in atrial fibrillation. Cerebrovasc Dis 30:389–395CrossRefPubMed Tu HT, Campbell BC, Christensen S, Collins M, De Silva DA, Butcher KS, Parsons MW, Desmond PM, Barber PA, Levi CR, Bladin CF, Donnan GA, Davis SM (2010) Pathophysiological determinants of worse stroke outcome in atrial fibrillation. Cerebrovasc Dis 30:389–395CrossRefPubMed
6.
Zurück zum Zitat Hart R, Pearce L, Aguilar M (2007) Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation. Ann Intern Med 146:857–867CrossRefPubMed Hart R, Pearce L, Aguilar M (2007) Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation. Ann Intern Med 146:857–867CrossRefPubMed
7.
Zurück zum Zitat Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B, Castella M, Diener HC, Heidbuchel H, Hendriks J, Hindricks G, Manolis AS, Oldgren J, Popescu BA, Schotten U, Van Putte B, Vardas P, Agewall S, Camm J, Baron Esquivias G, Budts W, Carerj S, Casselman F, Coca A, De Caterina R, Deftereos S, Dobrev D, Ferro JM, Filippatos G, Fitzsimons D, Gorenek B, Guenoun M, Hohnloser SH, Kolh P, Lip GY, Manolis A, McMurray J, Ponikowski P, Rosenhek R, Ruschitzka F, Savelieva I, Sharma S, Suwalski P, Tamargo JL, Taylor CJ, Van Gelder IC, Voors AA, Windecker S, Zamorano JL, Zeppenfeld K (2016) 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Europace 18:1609–1678CrossRefPubMed Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B, Castella M, Diener HC, Heidbuchel H, Hendriks J, Hindricks G, Manolis AS, Oldgren J, Popescu BA, Schotten U, Van Putte B, Vardas P, Agewall S, Camm J, Baron Esquivias G, Budts W, Carerj S, Casselman F, Coca A, De Caterina R, Deftereos S, Dobrev D, Ferro JM, Filippatos G, Fitzsimons D, Gorenek B, Guenoun M, Hohnloser SH, Kolh P, Lip GY, Manolis A, McMurray J, Ponikowski P, Rosenhek R, Ruschitzka F, Savelieva I, Sharma S, Suwalski P, Tamargo JL, Taylor CJ, Van Gelder IC, Voors AA, Windecker S, Zamorano JL, Zeppenfeld K (2016) 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Europace 18:1609–1678CrossRefPubMed
8.
Zurück zum Zitat Ruff CT, Giugliano RP, Braunwald E, Hoffman EB, Deenadayalu N, Ezekowitz MD, Camm AJ, Weitz JI, Lewis BS, Parkhomenko A, Yamashita T, Antman EM (2014) Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials. Lancet 383:955–962CrossRefPubMed Ruff CT, Giugliano RP, Braunwald E, Hoffman EB, Deenadayalu N, Ezekowitz MD, Camm AJ, Weitz JI, Lewis BS, Parkhomenko A, Yamashita T, Antman EM (2014) Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials. Lancet 383:955–962CrossRefPubMed
9.
Zurück zum Zitat Sjögren V, Byström B, Renlund H, Svensson PJ, Oldgren J, Norrving B, Själander A (2017) Non-vitamin K oral anticoagulants are non-inferior for stroke prevention but cause fewer major bleedings than well-managed warfarin: a retrospective register study. PLOS ONE 12(7):e181000CrossRefPubMedPubMedCentral Sjögren V, Byström B, Renlund H, Svensson PJ, Oldgren J, Norrving B, Själander A (2017) Non-vitamin K oral anticoagulants are non-inferior for stroke prevention but cause fewer major bleedings than well-managed warfarin: a retrospective register study. PLOS ONE 12(7):e181000CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Kakkar AK, Mueller I, Bassand JP, Fitzmaurice DA, Goldhaber SZ, Goto S, Haas S, Hacke W, Lip GY, Mantovani LG, Turpie AG, van Eickels M, Misselwitz F, Rushton-Smith S, Kayani G, Wilkinson P, Verheugt FW, Registry Investigators GARFIELD (2013) Risk profiles and antithrombotic treatment of patients newly diagnosed with atrial fibrillation at risk of stroke: perspectives from the international, observational, prospective GARFIELD registry. PLOS ONE 8:e63479CrossRefPubMedPubMedCentral Kakkar AK, Mueller I, Bassand JP, Fitzmaurice DA, Goldhaber SZ, Goto S, Haas S, Hacke W, Lip GY, Mantovani LG, Turpie AG, van Eickels M, Misselwitz F, Rushton-Smith S, Kayani G, Wilkinson P, Verheugt FW, Registry Investigators GARFIELD (2013) Risk profiles and antithrombotic treatment of patients newly diagnosed with atrial fibrillation at risk of stroke: perspectives from the international, observational, prospective GARFIELD registry. PLOS ONE 8:e63479CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Yao X, Abraham NS, Alexander GC, Crown W, Montori VM, Sangaralingham LR, Gersh BJ, Shah ND, Noseworthy PA (2016) Effect of adherence to oral anticoagulants on risk of stroke and major bleeding among patients with atrial fibrillation. J Am Heart Assoc 23:5 Yao X, Abraham NS, Alexander GC, Crown W, Montori VM, Sangaralingham LR, Gersh BJ, Shah ND, Noseworthy PA (2016) Effect of adherence to oral anticoagulants on risk of stroke and major bleeding among patients with atrial fibrillation. J Am Heart Assoc 23:5
12.
Zurück zum Zitat Steinberg BA, Greiner MA, Hammill BG, Curtis LH, Benjamin EJ, Heckbert SR, Piccini JP (2015) Contraindications to anticoagulation therapy and eligibility for novel anticoagulants in older patients with atrial fibrillation. Cardiovasc Ther 33:177–183CrossRefPubMedPubMedCentral Steinberg BA, Greiner MA, Hammill BG, Curtis LH, Benjamin EJ, Heckbert SR, Piccini JP (2015) Contraindications to anticoagulation therapy and eligibility for novel anticoagulants in older patients with atrial fibrillation. Cardiovasc Ther 33:177–183CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat O’Brien EC, Holmes DN, Ansell JE, Allen LA, Hylek E, Kowey PR, Gersh BJ, Fonarow GC, Koller CR, Ezekowitz MD, Mahaffey KW, Chang P, Peterson ED, Piccini JP, Singer DE (2014) Physician practices regarding contraindications to oral anticoagulation in atrial fibrillation: findings from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF) registry. Am Heart J 167:601–609.e1CrossRefPubMed O’Brien EC, Holmes DN, Ansell JE, Allen LA, Hylek E, Kowey PR, Gersh BJ, Fonarow GC, Koller CR, Ezekowitz MD, Mahaffey KW, Chang P, Peterson ED, Piccini JP, Singer DE (2014) Physician practices regarding contraindications to oral anticoagulation in atrial fibrillation: findings from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF) registry. Am Heart J 167:601–609.e1CrossRefPubMed
14.
Zurück zum Zitat Blackshear JL, Odell JA (1996) Appendage obliteration to reduce stroke in cardiac surgical patients with atrial fibrillation. Ann Thorac Surg 61:755–759CrossRefPubMed Blackshear JL, Odell JA (1996) Appendage obliteration to reduce stroke in cardiac surgical patients with atrial fibrillation. Ann Thorac Surg 61:755–759CrossRefPubMed
15.
Zurück zum Zitat Demer LL, Tintut Y, Parhami F (2002) Novel mechanisms in accelerated vascular calcification in renal disease patients. Curr Opin Nephrol Hypertens 11:437–443CrossRefPubMed Demer LL, Tintut Y, Parhami F (2002) Novel mechanisms in accelerated vascular calcification in renal disease patients. Curr Opin Nephrol Hypertens 11:437–443CrossRefPubMed
16.
Zurück zum Zitat Reddy VY, Möbius-Winkler S, Miller MA, Neuzil P, Schuler G, Wiebe J, Sick P, Sievert H (2013) Left atrial appendage closure with the Watchman device in patients with a contraindication for oral anticoagulation: the ASAP study (ASA Plavix Feasibility Study With Watchman Left Atrial Appendage Closure Technology). J Am Coll Cardiol 61:2551–2556CrossRefPubMed Reddy VY, Möbius-Winkler S, Miller MA, Neuzil P, Schuler G, Wiebe J, Sick P, Sievert H (2013) Left atrial appendage closure with the Watchman device in patients with a contraindication for oral anticoagulation: the ASAP study (ASA Plavix Feasibility Study With Watchman Left Atrial Appendage Closure Technology). J Am Coll Cardiol 61:2551–2556CrossRefPubMed
17.
Zurück zum Zitat Holmes DR, Reddy VY, Buchbinder M, Stein K, Elletson M, Bergmann MW, Schmidt B, Saw J (2017) The assessment of the Watchman device in patients unsuitable for oral Anticoagulation (ASAP-TOO) trial. Am Heart J 189:68–74CrossRefPubMed Holmes DR, Reddy VY, Buchbinder M, Stein K, Elletson M, Bergmann MW, Schmidt B, Saw J (2017) The assessment of the Watchman device in patients unsuitable for oral Anticoagulation (ASAP-TOO) trial. Am Heart J 189:68–74CrossRefPubMed
18.
Zurück zum Zitat Nielsen-Kudsk JE, Johnsen SP, Wester P, Damgaard D, Airaksinen J, Lund J, De Backer O, Pakarinen S, Odenstedt J, Vikman S, Settergren M, Kongstad O, Rosenqvist M, Krieger DW (2017) Left atrial appendage occlusion versus standard medical care in patients with atrial fibrillation and intracerebral haemorrhage: a propensity score-matched follow-up study. EuroIntervention 13:371–378CrossRefPubMed Nielsen-Kudsk JE, Johnsen SP, Wester P, Damgaard D, Airaksinen J, Lund J, De Backer O, Pakarinen S, Odenstedt J, Vikman S, Settergren M, Kongstad O, Rosenqvist M, Krieger DW (2017) Left atrial appendage occlusion versus standard medical care in patients with atrial fibrillation and intracerebral haemorrhage: a propensity score-matched follow-up study. EuroIntervention 13:371–378CrossRefPubMed
19.
Zurück zum Zitat Schelleman H, Brensinger CM, Bilker WB, Hennessy S (2011) Antidepressant-warfarin interaction and associated gastrointestinal bleeding risk in a case-control study. PLOS ONE 6:e21447CrossRefPubMedPubMedCentral Schelleman H, Brensinger CM, Bilker WB, Hennessy S (2011) Antidepressant-warfarin interaction and associated gastrointestinal bleeding risk in a case-control study. PLOS ONE 6:e21447CrossRefPubMedPubMedCentral
20.
Zurück zum Zitat Witt DM, Delate T, Garcia DA, Clark NP, Hylek EM, Ageno W, Dentali F, Crowther MA (2012) Risk of thromboembolism, recurrent hemorrhage, and death after warfarin therapy interruption for gastrointestinal tract bleeding. Arch Intern Med 172:1484–1491CrossRefPubMed Witt DM, Delate T, Garcia DA, Clark NP, Hylek EM, Ageno W, Dentali F, Crowther MA (2012) Risk of thromboembolism, recurrent hemorrhage, and death after warfarin therapy interruption for gastrointestinal tract bleeding. Arch Intern Med 172:1484–1491CrossRefPubMed
21.
Zurück zum Zitat Qureshi W, Mittal C, Patsias I, Garikapati K, Kuchipudi A, Cheema G, Elbatta M, Alirhayim Z, Khalid F (2014) Restarting anticoagulation and outcomes after major gastrointestinal bleeding in atrial fibrillation. Am J Cardiol 113:662–668CrossRefPubMed Qureshi W, Mittal C, Patsias I, Garikapati K, Kuchipudi A, Cheema G, Elbatta M, Alirhayim Z, Khalid F (2014) Restarting anticoagulation and outcomes after major gastrointestinal bleeding in atrial fibrillation. Am J Cardiol 113:662–668CrossRefPubMed
22.
Zurück zum Zitat Lee SJ, Shin DH, Hwang HJ, Kim JY, Pak HN, Lee MH, Joung B (2012) Bleeding risk and major adverse events in patients with previous ulcer on oral anticoagulation therapy. Am J Cardiol 110:373–377CrossRefPubMed Lee SJ, Shin DH, Hwang HJ, Kim JY, Pak HN, Lee MH, Joung B (2012) Bleeding risk and major adverse events in patients with previous ulcer on oral anticoagulation therapy. Am J Cardiol 110:373–377CrossRefPubMed
23.
Zurück zum Zitat Lee SJ, Sung JH, Kim JB, Ahn MS, Lee HY, Uhm JS, Pak HN, Lee MH, Kim JY, Joung B (2016) The safety and efficacy of vitamin K antagonist in atrial fibrillation patients with previous ulcer bleeding: long-term results from a multicenter study. Medicine (Baltimore) 95:e5467CrossRef Lee SJ, Sung JH, Kim JB, Ahn MS, Lee HY, Uhm JS, Pak HN, Lee MH, Kim JY, Joung B (2016) The safety and efficacy of vitamin K antagonist in atrial fibrillation patients with previous ulcer bleeding: long-term results from a multicenter study. Medicine (Baltimore) 95:e5467CrossRef
24.
Zurück zum Zitat Lempereur M, Aminian A, Freixa X, Gafoor S, Shakir S, Omran H, Berti S, Santoro G, Kefer J, Landmesser U, Nielsen-Kudsk JE, Cruz-Gonzalez I, Kanagaratnam P, Nietlispach F, Ibrahim R, Sievert H, Schillinger W, Park JW, Gloekler S, Tzikas A (2017) Left atrial appendage occlusion in patients with atrial fibrillation and previous major gastrointestinal bleeding (from the Amplatzer Cardiac Plug Multicenter Rregistry). Am J Cardiol 120:414–420CrossRefPubMed Lempereur M, Aminian A, Freixa X, Gafoor S, Shakir S, Omran H, Berti S, Santoro G, Kefer J, Landmesser U, Nielsen-Kudsk JE, Cruz-Gonzalez I, Kanagaratnam P, Nietlispach F, Ibrahim R, Sievert H, Schillinger W, Park JW, Gloekler S, Tzikas A (2017) Left atrial appendage occlusion in patients with atrial fibrillation and previous major gastrointestinal bleeding (from the Amplatzer Cardiac Plug Multicenter Rregistry). Am J Cardiol 120:414–420CrossRefPubMed
25.
Zurück zum Zitat Holmes DR, Reddy VY, Turi ZG, Doshi SK, Sievert H, Buchbinder M, Mullin CM, Sick P, PROTECT AF Investigators (2009) Percutaneous closure of the left atrial appendage versus warfarin therapy for prevention of stroke in patients with atrial fibrillation: a randomised non-inferiority trial. Lancet 374:534–542CrossRefPubMed Holmes DR, Reddy VY, Turi ZG, Doshi SK, Sievert H, Buchbinder M, Mullin CM, Sick P, PROTECT AF Investigators (2009) Percutaneous closure of the left atrial appendage versus warfarin therapy for prevention of stroke in patients with atrial fibrillation: a randomised non-inferiority trial. Lancet 374:534–542CrossRefPubMed
26.
Zurück zum Zitat Reddy VY, Doshi SK, Sievert H, Buchbinder M, Neuzil P, Huber K, Halperin JL, Holmes D, PROTECT AF Investigators (2013) Percutaneous left atrial appendage closure for stroke prophylaxis in patients with atrial fibrillation: 2.3-Year Follow-up of the PROTECT AF (Watchman Left Atrial Appendage System for Embolic Protection in Patients with Atrial Fibrillation) Trial. Circulation 127:720–729CrossRefPubMed Reddy VY, Doshi SK, Sievert H, Buchbinder M, Neuzil P, Huber K, Halperin JL, Holmes D, PROTECT AF Investigators (2013) Percutaneous left atrial appendage closure for stroke prophylaxis in patients with atrial fibrillation: 2.3-Year Follow-up of the PROTECT AF (Watchman Left Atrial Appendage System for Embolic Protection in Patients with Atrial Fibrillation) Trial. Circulation 127:720–729CrossRefPubMed
27.
Zurück zum Zitat Holmes DR Jr, Kar S, Price MJ, Whisenant B, Sievert H, Doshi SK, Huber K, Reddy VY (2014) Prospective randomized evaluation of the Watchman Left Atrial Appendage Closure device in patients with atrial fibrillation versus long-term warfarin therapy: the PREVAIL trial. J Am Coll Cardiol 64:1–12CrossRefPubMed Holmes DR Jr, Kar S, Price MJ, Whisenant B, Sievert H, Doshi SK, Huber K, Reddy VY (2014) Prospective randomized evaluation of the Watchman Left Atrial Appendage Closure device in patients with atrial fibrillation versus long-term warfarin therapy: the PREVAIL trial. J Am Coll Cardiol 64:1–12CrossRefPubMed
28.
Zurück zum Zitat Holmes DR Jr, Doshi SK, Kar S, Price MJ, Sanchez JM, Sievert H, Valderrabano M, Reddy VY (2015) Left atrial appendage closure as an alternative to warfarin for stroke prevention in atrial fibrillation: a patient-level meta-analysis. J Am Coll Cardiol 65:2614–2623CrossRefPubMed Holmes DR Jr, Doshi SK, Kar S, Price MJ, Sanchez JM, Sievert H, Valderrabano M, Reddy VY (2015) Left atrial appendage closure as an alternative to warfarin for stroke prevention in atrial fibrillation: a patient-level meta-analysis. J Am Coll Cardiol 65:2614–2623CrossRefPubMed
29.
Zurück zum Zitat Hansen ML, Sørensen R, Clausen MT, Fog-Petersen ML, Raunsø J, Gadsbøll N, Gislason GH, Folke F, Andersen SS, Schramm TK, Abildstrøm SZ, Poulsen HE, Køber L, Torp-Pedersen C (2010) Risk of bleeding with single, dual, or triple therapy with warfarin, aspirin, and clopidogrel in patients with atrial fibrillation. Arch Intern Med 170:1433–1441CrossRefPubMed Hansen ML, Sørensen R, Clausen MT, Fog-Petersen ML, Raunsø J, Gadsbøll N, Gislason GH, Folke F, Andersen SS, Schramm TK, Abildstrøm SZ, Poulsen HE, Køber L, Torp-Pedersen C (2010) Risk of bleeding with single, dual, or triple therapy with warfarin, aspirin, and clopidogrel in patients with atrial fibrillation. Arch Intern Med 170:1433–1441CrossRefPubMed
30.
Zurück zum Zitat Lee SH, Cho JY, Joo HJ, Park JH, Hong S, Yu CW, Lim DS (2016) A comparison of clinical outcomes between triple antithrombotic therapy versus dual antiplatelet with left atrial appendage occlusion in patients with atrial fibrillation undergoing drug-eluting stent implantation. J Am Coll Cardiol 68(Suppl):B252CrossRef Lee SH, Cho JY, Joo HJ, Park JH, Hong S, Yu CW, Lim DS (2016) A comparison of clinical outcomes between triple antithrombotic therapy versus dual antiplatelet with left atrial appendage occlusion in patients with atrial fibrillation undergoing drug-eluting stent implantation. J Am Coll Cardiol 68(Suppl):B252CrossRef
31.
Zurück zum Zitat Meier B, Blaauw Y, Khattab AA, Lewalter T, Sievert H, Tondo C, Glikson M (2014) EHRA/EAPCI expert consensus statement on catheter-based left atrial appendage occlusion. Europace 16:1397–1416CrossRefPubMed Meier B, Blaauw Y, Khattab AA, Lewalter T, Sievert H, Tondo C, Glikson M (2014) EHRA/EAPCI expert consensus statement on catheter-based left atrial appendage occlusion. Europace 16:1397–1416CrossRefPubMed
32.
Zurück zum Zitat Lee JM, Shim J, Uhm JS, Kim YJ, Lee HJ, Pak HN, Lee MH, Joung B (2014) Impact of increased orifice size and decreased flow velocity of left atrial appendage on stroke in nonvalvular atrial fibrillation. Am J Cardiol 113:963–969CrossRefPubMed Lee JM, Shim J, Uhm JS, Kim YJ, Lee HJ, Pak HN, Lee MH, Joung B (2014) Impact of increased orifice size and decreased flow velocity of left atrial appendage on stroke in nonvalvular atrial fibrillation. Am J Cardiol 113:963–969CrossRefPubMed
33.
Zurück zum Zitat Fukushima K, Fukushima N, Kato K, Ejima K, Sato H, Fukushima K, Saito C, Hayashi K, Arai K, Manaka T, Ashihara K, Shoda M, Hagiwara N (2016) Correlation between left atrial appendage morphology and flow velocity in patients with paroxysmal atrial fibrillation. Eur Heart J Cardiovasc Imaging 17:59–66PubMed Fukushima K, Fukushima N, Kato K, Ejima K, Sato H, Fukushima K, Saito C, Hayashi K, Arai K, Manaka T, Ashihara K, Shoda M, Hagiwara N (2016) Correlation between left atrial appendage morphology and flow velocity in patients with paroxysmal atrial fibrillation. Eur Heart J Cardiovasc Imaging 17:59–66PubMed
34.
Zurück zum Zitat Rillig A, Tilz RR, Lin T, Fink T, Heeger CH, Arya A, Metzner A, Mathew S, Wissner E, Makimoto H, Wohlmuth P, Kuck KH, Ouyang F (2016) Unexpectedly high incidence of stroke and left atrial appendage thrombus formation after electrical isolation of the left atrial appendage for the treatment of atrial tachyarrhythmias. Circ Arrhythm Electrophysiol 9:e3461CrossRefPubMed Rillig A, Tilz RR, Lin T, Fink T, Heeger CH, Arya A, Metzner A, Mathew S, Wissner E, Makimoto H, Wohlmuth P, Kuck KH, Ouyang F (2016) Unexpectedly high incidence of stroke and left atrial appendage thrombus formation after electrical isolation of the left atrial appendage for the treatment of atrial tachyarrhythmias. Circ Arrhythm Electrophysiol 9:e3461CrossRefPubMed
35.
Zurück zum Zitat Panikker S, Jarman JW, Virmani R, Kutys R, Haldar S, Lim E, Butcher C, Khan H, Mantziari L, Nicol E, Foran JP, Markides V, Wong T (2016) Left atrial appendage electrical isolation and concomitant device occlusion to treat persistent atrial fibrillation: a first-in-human safety, feasibility, and efficacy study. Circ Arrhythm Electrophysiol 9:e3710CrossRefPubMed Panikker S, Jarman JW, Virmani R, Kutys R, Haldar S, Lim E, Butcher C, Khan H, Mantziari L, Nicol E, Foran JP, Markides V, Wong T (2016) Left atrial appendage electrical isolation and concomitant device occlusion to treat persistent atrial fibrillation: a first-in-human safety, feasibility, and efficacy study. Circ Arrhythm Electrophysiol 9:e3710CrossRefPubMed
36.
Zurück zum Zitat Ailawadi G, Gerdisch MW, Harvey RL et al (2011) Exclusion of the left atrial appendage with a novel device: early results of a multicenter trial. J Thorac Cardiovasc Surg 142:1002–1009.e1CrossRefPubMed Ailawadi G, Gerdisch MW, Harvey RL et al (2011) Exclusion of the left atrial appendage with a novel device: early results of a multicenter trial. J Thorac Cardiovasc Surg 142:1002–1009.e1CrossRefPubMed
37.
Zurück zum Zitat Emmert MY, Puippe G, Baumüller S, Alkadhi H, Landmesser U, Plass A, Bettex D, Scherman J, Grünenfelder J, Genoni M, Falk V, Salzberg SP (2014) Safe, effective and durable epicardial left atrial appendage clip occlusion in patients with atrial fibrillation undergoing cardiac surgery: first long-term results from a prospective device trial. Eur J Cardiothorac Surg 45:126–131CrossRefPubMed Emmert MY, Puippe G, Baumüller S, Alkadhi H, Landmesser U, Plass A, Bettex D, Scherman J, Grünenfelder J, Genoni M, Falk V, Salzberg SP (2014) Safe, effective and durable epicardial left atrial appendage clip occlusion in patients with atrial fibrillation undergoing cardiac surgery: first long-term results from a prospective device trial. Eur J Cardiothorac Surg 45:126–131CrossRefPubMed
38.
Zurück zum Zitat Bartus K, Han FT, Bednarek J, Myc J, Kapelak B, Sadowski J, Lelakowski J, Bartus S, Yakubov SJ, Lee RJ (2013) Percutaneous left atrial appendage suture ligation using the LARIAT device in patients with atrial fibrillation: initial clinical experience. J Am Coll Cardiol 62:108–118CrossRefPubMed Bartus K, Han FT, Bednarek J, Myc J, Kapelak B, Sadowski J, Lelakowski J, Bartus S, Yakubov SJ, Lee RJ (2013) Percutaneous left atrial appendage suture ligation using the LARIAT device in patients with atrial fibrillation: initial clinical experience. J Am Coll Cardiol 62:108–118CrossRefPubMed
39.
Zurück zum Zitat Lakkireddy D, Afzal MR, Lee RJ, Nagaraj H, Tschopp D, Gidney B, Ellis C, Altman E, Lee B, Kar S, Bhadwar N, Sanchez M, Gadiyaram V, Evonich R, Rasekh A, Cheng J, Cuoco F, Chandhok S, Gunda S, Reddy M, Atkins D, Bommana S, Cuculich P, Gibson D, Nath J, Ferrell R, Matthew E, Wilber D (2016) Short and long-term outcomes of percutaneous left atrial appendage suture ligation: results from a US multicenter evaluation. Heart Rhythm 13:1030–1036CrossRefPubMed Lakkireddy D, Afzal MR, Lee RJ, Nagaraj H, Tschopp D, Gidney B, Ellis C, Altman E, Lee B, Kar S, Bhadwar N, Sanchez M, Gadiyaram V, Evonich R, Rasekh A, Cheng J, Cuoco F, Chandhok S, Gunda S, Reddy M, Atkins D, Bommana S, Cuculich P, Gibson D, Nath J, Ferrell R, Matthew E, Wilber D (2016) Short and long-term outcomes of percutaneous left atrial appendage suture ligation: results from a US multicenter evaluation. Heart Rhythm 13:1030–1036CrossRefPubMed
40.
Zurück zum Zitat Tzikas A, Holmes DR Jr, Gafoor S, Ruiz CE, Blomström-Lundqvist C, Diener HC, Cappato R, Kar S, Lee RJ, Byrne RA, Ibrahim R, Lakkireddy D, Soliman OI, Nabauer M, Schneider S, Brachmann J, Saver JL, Tiemann K, Sievert H, Camm AJ, Lewalter T (2017) Percutaneous left atrial appendage occlusion: the Munich consensus document on definitions, endpoints, and data collection requirements for clinical studies. Europace 19:4–15PubMed Tzikas A, Holmes DR Jr, Gafoor S, Ruiz CE, Blomström-Lundqvist C, Diener HC, Cappato R, Kar S, Lee RJ, Byrne RA, Ibrahim R, Lakkireddy D, Soliman OI, Nabauer M, Schneider S, Brachmann J, Saver JL, Tiemann K, Sievert H, Camm AJ, Lewalter T (2017) Percutaneous left atrial appendage occlusion: the Munich consensus document on definitions, endpoints, and data collection requirements for clinical studies. Europace 19:4–15PubMed
41.
Zurück zum Zitat Tzikas A, Shakir S, Gafoor S, Omran H, Berti S, Santoro G, Kefer J, Landmesser U, Nielsen-Kudsk JE, Cruz-Gonzalez I, Sievert H, Tichelbäcker T, Kanagaratnam P, Nietlispach F, Aminian A, Kasch F, Freixa X, Danna P, Rezzaghi M, Vermeersch P, Stock F, Stolcova M, Costa M, Ibrahim R, Schillinger W, Meier B, Park JW (2016) Left atrial appendage occlusion for stroke prevention in atrial fibrillation: multicentre experience with the AMPLATZER cardiac plug. EuroIntervention 11:1170–1179CrossRefPubMed Tzikas A, Shakir S, Gafoor S, Omran H, Berti S, Santoro G, Kefer J, Landmesser U, Nielsen-Kudsk JE, Cruz-Gonzalez I, Sievert H, Tichelbäcker T, Kanagaratnam P, Nietlispach F, Aminian A, Kasch F, Freixa X, Danna P, Rezzaghi M, Vermeersch P, Stock F, Stolcova M, Costa M, Ibrahim R, Schillinger W, Meier B, Park JW (2016) Left atrial appendage occlusion for stroke prevention in atrial fibrillation: multicentre experience with the AMPLATZER cardiac plug. EuroIntervention 11:1170–1179CrossRefPubMed
42.
Zurück zum Zitat Boersma LV, Ince H, Kische S, Pokushalov E, Schmitz T, Schmidt B, Gori T, Meincke F, Protopopov AV, Betts T, Foley D, Sievert H, Mazzone P, De Potter T, Vireca E, Stein K, Bergmann MW, EWOLUTION Investigators (2017) Efficacy and safety of left atrial appendage closure with WATCHMAN in patients with or without contraindication to oral anticoagulation: 1‑Year follow-up outcome data of the EWOLUTION trial. Heart Rhythm 14(9):1302–1308CrossRefPubMed Boersma LV, Ince H, Kische S, Pokushalov E, Schmitz T, Schmidt B, Gori T, Meincke F, Protopopov AV, Betts T, Foley D, Sievert H, Mazzone P, De Potter T, Vireca E, Stein K, Bergmann MW, EWOLUTION Investigators (2017) Efficacy and safety of left atrial appendage closure with WATCHMAN in patients with or without contraindication to oral anticoagulation: 1‑Year follow-up outcome data of the EWOLUTION trial. Heart Rhythm 14(9):1302–1308CrossRefPubMed
43.
Zurück zum Zitat Reddy VY, Akehurst RL, Armstrong SO, Amorosi SL, Brereton N, Hertz DS, Holmes DR Jr. (2016) Cost effectiveness of left atrial appendage closure with the Watchman device for atrial fibrillation patients with absolute contraindications to warfarin. Europace 18:979–986CrossRefPubMedPubMedCentral Reddy VY, Akehurst RL, Armstrong SO, Amorosi SL, Brereton N, Hertz DS, Holmes DR Jr. (2016) Cost effectiveness of left atrial appendage closure with the Watchman device for atrial fibrillation patients with absolute contraindications to warfarin. Europace 18:979–986CrossRefPubMedPubMedCentral
Metadaten
Titel
Aktuelle Indikationsstellung zur Vorhofohrokkluderimplantation
verfasst von
Clemens Jilek, PD Dr.
Thorsten Lewalter, Prof. Dr. med.
Publikationsdatum
25.10.2017
Verlag
Springer Medizin
Erschienen in
Herzschrittmachertherapie + Elektrophysiologie / Ausgabe 4/2017
Print ISSN: 0938-7412
Elektronische ISSN: 1435-1544
DOI
https://doi.org/10.1007/s00399-017-0531-1

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