Venkat Vuddanda

Catheter Ablation for Atrial Fibrillation in Patients With Watchman Left Atrial Appendage Occlusion Device: Results from a Multicenter Registry

There have been an increasing number of atrial fibrillation (AF) patients with Watchman left atrial appendage occlusion (LAAO) device, requiring catheter ablation (CA) for maintenance of normal sinus rhythm. In this study, we describe our experience with the feasibility and safety of CA in patients with a preexisting Watchman LAAO device.

Safety profiles of percutaneous left atrial appendage closure devices: An analysis of the Food and Drug Administration Manufacturer and User Facility Device Experience (MAUDE) database from 2009 to 2016

Percutaneous left atrial appendage closure (LAAC) is a viable option for AF patients who are unable to tolerate long‐term oral anticoagulation (OAC).

Five years of keeping a watch on the left atrial appendage—how has the WATCHMAN fared?

Left atrial appendage closure (LAAC) is a promising site-directed therapy for stroke prevention in patients with non-valvular atrial fibrillation (AF) who are ineligible or contraindicated for long-term oral anticoagulation. A variety of LAAC modalities are available, including percutaneous endocardial occluder devices such as WATCHMANTM (Boston Scientific Corp., Marlborough, MA, USA), and an ever-increasing body of evidence is helping to define the optimal use of each technique. Similarly increased experience with LAAC has revealed challenges such as device-related thrombi and peri-device leaks for which the long-term significance and appropriate management are areas of active investigation. We review the evolution and long-term outcomes with the WATCHMANTM device with particular emphasis on the nuances of its use and its role in the broader landscape of appendageology.

USE OF AN ESOPHAGEAL RETRACTOR TO PREVENT THERMAL INJURIES DURING ATRIAL FIBRILLATION ABLATION: A MULTI-CENTER EXPERIENCE

Background: Rapid and significant rise in esophageal temperature (ET) during radiofrequency ablation (RFA) for atrial fibrillation (AF) can be an indicator of an esophageal injury and limits our ability to achieve pulmonary vein isolation(PVI) by incomplete left atrial posterior wall (PW)ablation.

Acute Coronary Syndromes in Heart Transplant Recipients (From A National Database Analysis)

With an expanding and aging heart transplant population, the incidence of acute coronary syndromes (ACS) is expected to increase. Our study aims to report current trends in in-hospital management and outcomes in heart transplant recipients presenting with ACS. We conducted an analysis of the National Inpatient Sample (2007 to 2014) to study the trends in hospitalization, in-hospital management, and outcomes in heart transplant recipients with a primary diagnosis of ACS. We included patients with ST elevation myocardial infarction (STEMI), non-STEMI (NSTEMI) and those with unstable angina pectoris (UAP). A total of 1,621 ACS (NSTEMI/UAP-76% vs STEMI-24%) hospitalizations were identified. Despite 1,327 (81%) of patients who underwent left heart catheterization, coronary revascularization was performed in only 576 patients (36%). Mortality was significantly higher in patients presenting with STEMI versus NSTEMI/UAP (28% vs 11%, respectively; p <0.05) and those who did not undergo revascularization (19% vs 7%; p <0.05). Cardiogenic shock (CS) was diagnosed in 14.5% patients. Mechanical circulatory support utilization was higher in CS group compared with non-CS group (69% vs 2.8%; p <0.05), as was in-hospital mortality (39% vs 10%; p <0.05). Repeat transplantation during the index hospitalization was done in 4.5% of ACS patients. In conclusion, in heart transplant recipients, ACS is associated with a high incidence of CS and in-hospital mortality. Aggressive treatment strategy that includes revascularization, mechanical circulatory support use (in those developing CS), and urgent retransplantation in suitable candidates seems to lead to better results than a more conservative strategy.

REAL WORLD BATTERY LONGEVITY OF ST. JUDE MEDICAL IMPLANTABLE CARDIOVERTER-DEFIBRILLATORS INCLUDED IN THE ADVISORY FOR PREMATURE BATTERY DEPLETION

Background: Very recently St Jude Medical (SJM) released an advisory regarding premature battery depletion in a family of implantable cardioverter-defibrillators (ICDs) including biventricular cardiac defibrillators (CRTDs). There have been reported cases of loss of pacing and inability to

UNINTERRUPTED NON-VITAMIN K ANTAGONIST ORAL ANTICOAGULANTS VERSUS WARFARIN IN PATIENTS UNDERGOING CARDIAC IMPLANTABLE ELECTRONIC DEVICE IMPLANTATION: A META-ANALYSIS

Background: Uninterrupted use of anticoagulation is currently preferred over bridging therapy during cardiac implantable electronic device (CIED) implantation. However, there is limited experience with uninterrupted non-vitamin K antagonist oral anticoagulants (NOAC) in this setting. We performed a

IMPLANTABLE CARDIOVERTER DEFIBRILLATOR FOR THE PREVENTION OF MORTALITY IN NON-ISCHEMIC CARDIOMYOPATHY: A META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS

Background: The survival benefit of Implantable cardioverter defibrillator (ICD) in ischemic cardiomyopathy with an ejection fraction (EF) of ≤35% is well established. However, there remains controversy regarding its benefit in non-ischemic cardiomyopathy (NICM). We performed a meta-analysis

LEFT ATRIAL APPENDAGE LIGATION WITH LARIAT DEVICE: A SYSTEMATIC REVIEW AND META-ANALYSIS

Background: The LARIAT device is a percutaneous endo-epicardial left atrial appendage (LAA) exclusion system that is currently performed in high risk atrial fibrillation (AF) patients intolerant to oral anticoagulation for stroke prevention and maybe reduction of AF burden. Methods: A comprehensive

PERI-PROCEDURAL USE OF NOVEL ORAL ANTICOAGULATION AGENTS DURING CARDIAC DEVICE IMPLANTATION: ARE THEY SAFE?

Background: Safety of peri-procedural use of novel oral anticoagulation agents (NOACs) during cardiac device implantation has been suggested in small observational studies. Larger data affirming its safety is lacking. Methods: We performed a multicenter evaluation of safety of uninterrupted