Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Editorial
. 2017 Jan;9(1):1-4.
doi: 10.21037/jtd.2017.01.01.

Is left atrial appendage isolation a pyrrhic victory in the effort to treat atrial fibrillation?

T Jared Bunch  1 , John D Day  2
Affiliations
Editorial

Is left atrial appendage isolation a pyrrhic victory in the effort to treat atrial fibrillation?

T Jared Bunch et al. J Thorac Dis. 2017 Jan.
No abstract available

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
In panel (A), a 4-chamber transthoracic echocardiogram image is shown in a patient with diastolic dysfunction of the left ventricle (LV), multiple ablations including a surgical Maze procedure, and moderate-severe right (RA) and severe left (LA) enlargement; in panel (B), the same image is shown with Color Doppler imaging of the mitral valve that shows only trace mitral regurgitation (arrow); (C) shows a transesophageal image of the LA and left atrial appendage. In the dilated appendage there is dense atrial contrast (arrows) consistent with stasis and high-risk thrombotic state; (D) shows the left atrial pressure tracings. The wave of atrial contraction is small consistent with systolic dysfunction. The c wave from ventricular contraction and the subsequent mitral valve movement into the left atrium is augmented. The v wave is significantly augmented in the absence of mitral regurgitation a finding in the setting of the others mention diagnostic of stiff left atrial syndrome.
See this image and copyright information in PMC

Comment on

References

    1. Dzeshka MS, Lip GY, Snezhitskiy V, et al. Cardiac Fibrosis in Patients With Atrial Fibrillation: Mechanisms and Clinical Implications. J Am Coll Cardiol 2015;66:943-59. 10.1016/j.jacc.2015.06.1313 - DOI - PubMed
    1. Bunch TJ, May HT. Atrial fibrillation: a risk factor or risk marker? Eur Heart J 2016;37:2890-2. 10.1093/eurheartj/ehw313 - DOI - PubMed
    1. Calkins H, Kuck KH, Cappato R, et al. 2012 HRS/EHRA/ECAS expert consensus statement on catheter and surgical ablation of atrial fibrillation: recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial design: a report of the Heart Rhythm Society (HRS) Task Force on Catheter and Surgical Ablation of Atrial Fibrillation. Developed in partnership with the European Heart Rhythm Association (EHRA), a registered branch of the European Society of Cardiology (ESC) and the European Cardiac Arrhythmia Society (ECAS); and in collaboration with the American College of Cardiology (ACC), American Heart Association (AHA), the Asia Pacific Heart Rhythm Society (APHRS), and the Society of Thoracic Surgeons (STS). Endorsed by the governing bodies of the American College of Cardiology Foundation, the American Heart Association, the European Cardiac Arrhythmia Society, the European Heart Rhythm Association, the Society of Thoracic Surgeons, the Asia Pacific Heart Rhythm Society, and the Heart Rhythm Society. Heart Rhythm 2012;9:632-696.e21. 10.1016/j.hrthm.2011.12.016 - DOI - PubMed
    1. Wilber DJ, Pappone C, Neuzil P, et al. Comparison of antiarrhythmic drug therapy and radiofrequency catheter ablation in patients with paroxysmal atrial fibrillation: a randomized controlled trial. JAMA 2010;303:333-40. 10.1001/jama.2009.2029 - DOI - PubMed
    1. Stabile G, Bertaglia E, Senatore G, et al. Catheter ablation treatment in patients with drug-refractory atrial fibrillation: a prospective, multi-centre, randomized, controlled study (Catheter Ablation For The Cure Of Atrial Fibrillation Study). Eur Heart J 2006;27:216-21. 10.1093/eurheartj/ehi583 - DOI - PubMed

LinkOut - more resources