NEW YORK CITY -- The persistent peridevice leaks in percutaneous left atrial appendage (LAA) closure may be addressed by applying pulsed field ablation (PFA) during the procedure, the STUN-AF study suggested.
In this observational cohort study of 327 people undergoing concomitant PFA for atrial fibrillation (Afib) and LAA closure at three U.S. centers, it was apparent that those who got PFA on the LAA were more likely to have no peridevice leaks on imaging at both 4 months (71% vs 36%, P<0.001) and 12 months (96% vs 58%, P<0.001).
Ablation of the LAA, a technique to eliminate residual contractility just before LAA occlusion, thus reduced peridevice leaks and was backed by a correlation in lower LAA emptying velocities, as well as favorable safety data, reported Vivek Reddy, MD, of Mount Sinai Fuster Heart Hospital in New York City.
"The physiological conclusion is that residual contractility is a modifiable contributor to an incomplete appendage seal," Reddy said at the New York Valves annual meeting hosted by the Cardiovascular Research Foundation. "Consider this in patients undergoing concomitant ablation."
"We would certainly want to see a future prospective trial, and I think this has implications for future appendage device iterations," he added.
