Mechanical function of the left atrium is improved with epicardial ligation of the left atrial appendage: Insights from the LAFIT-LARIAT Registry

Tawseef Dar, Muhammad R. Afzal, Bharath Yarlagadda, Shelby Kutty, Quanliang Shang, Sampath Gunda, Anweshan Samanta, Jahnavi Thummaluru, Kedareeshwar S. Arukala, Arun Kanmanthareddy, Madhu Reddy, Donita Atkins, Sudharani Bommana, Buddhadeb Dawn, Dhanunjaya Lakkireddy

Research output: Contribution to journalArticle

Abstract

Background: Left atrial (LA) strain (ε) and ε rate (SR) analysis by 2-dimensional speckle tracking echocardiography is a novel method for functional assessment of the LA. Objective: The purpose of this study was to determine the impact of left atrial appendage (LAA) exclusion by Lariat epicardial ligation on mechanical function of the LA by performing ε and SR analysis before and after the procedure. Methods: A total of 66 patients who underwent successful LAA exclusion were included in the study. Of these 66 patients, 32 had adequate paired data for ε and SR analysis. SR during ventricular systole (LA-SRs) represents LA reservoir function, and SR during early ventricular diastole (LA-SRe) represents LA conduit function. ε and SR were determined from apical 4- and 2-chamber views using the electrocardiographic QRS as a reference point. LA volume index as surrogate for LA remodeling was measured from apical views. Results: Mean patient age was 70 ± 9.2 years. LAA ligation resulted in improved reservoir function (LA-SRs: pre 0.72, confidence interval [CI] 0.63–0.83 vs post 0.81, CI 0.73–0.98; P =.043) and conduit function (LA-SRe: pre 0.74, CI 0.67–0.99 vs post 0.89, CI 0.82–1.07; P =.025). LA volume index improved significantly with the Lariat (pre 35.4, CI 29.4–37.2 vs post 29.2, CI 28.2–35.9; P <.023). Conclusion: LAA exclusion seems to improve mechanical function of the LA and results in reverse LA remodeling.

Original languageEnglish (US)
Pages (from-to)955-959
Number of pages5
JournalHeart Rhythm
Volume15
Issue number7
DOIs
StatePublished - Jul 1 2018
Externally publishedYes

Fingerprint

Left Atrial Function
Atrial Appendage
Heart Atria
Ligation
Registries
Confidence Intervals
Atrial Remodeling
Diastole
Systole
Echocardiography

Keywords

  • Left atrial appendage
  • Remodeling
  • Speckle tracking echocardiography
  • Strain analysis
  • Suture exclusion

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Mechanical function of the left atrium is improved with epicardial ligation of the left atrial appendage : Insights from the LAFIT-LARIAT Registry. / Dar, Tawseef; Afzal, Muhammad R.; Yarlagadda, Bharath; Kutty, Shelby; Shang, Quanliang; Gunda, Sampath; Samanta, Anweshan; Thummaluru, Jahnavi; Arukala, Kedareeshwar S.; Kanmanthareddy, Arun; Reddy, Madhu; Atkins, Donita; Bommana, Sudharani; Dawn, Buddhadeb; Lakkireddy, Dhanunjaya.

In: Heart Rhythm, Vol. 15, No. 7, 01.07.2018, p. 955-959.

Research output: Contribution to journalArticle

Dar, T, Afzal, MR, Yarlagadda, B, Kutty, S, Shang, Q, Gunda, S, Samanta, A, Thummaluru, J, Arukala, KS, Kanmanthareddy, A, Reddy, M, Atkins, D, Bommana, S, Dawn, B & Lakkireddy, D 2018, 'Mechanical function of the left atrium is improved with epicardial ligation of the left atrial appendage: Insights from the LAFIT-LARIAT Registry', Heart Rhythm, vol. 15, no. 7, pp. 955-959. https://doi.org/10.1016/j.hrthm.2018.02.022
Dar, Tawseef ; Afzal, Muhammad R. ; Yarlagadda, Bharath ; Kutty, Shelby ; Shang, Quanliang ; Gunda, Sampath ; Samanta, Anweshan ; Thummaluru, Jahnavi ; Arukala, Kedareeshwar S. ; Kanmanthareddy, Arun ; Reddy, Madhu ; Atkins, Donita ; Bommana, Sudharani ; Dawn, Buddhadeb ; Lakkireddy, Dhanunjaya. / Mechanical function of the left atrium is improved with epicardial ligation of the left atrial appendage : Insights from the LAFIT-LARIAT Registry. In: Heart Rhythm. 2018 ; Vol. 15, No. 7. pp. 955-959.
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abstract = "Background: Left atrial (LA) strain (ε) and ε rate (SR) analysis by 2-dimensional speckle tracking echocardiography is a novel method for functional assessment of the LA. Objective: The purpose of this study was to determine the impact of left atrial appendage (LAA) exclusion by Lariat epicardial ligation on mechanical function of the LA by performing ε and SR analysis before and after the procedure. Methods: A total of 66 patients who underwent successful LAA exclusion were included in the study. Of these 66 patients, 32 had adequate paired data for ε and SR analysis. SR during ventricular systole (LA-SRs) represents LA reservoir function, and SR during early ventricular diastole (LA-SRe) represents LA conduit function. ε and SR were determined from apical 4- and 2-chamber views using the electrocardiographic QRS as a reference point. LA volume index as surrogate for LA remodeling was measured from apical views. Results: Mean patient age was 70 ± 9.2 years. LAA ligation resulted in improved reservoir function (LA-SRs: pre 0.72, confidence interval [CI] 0.63–0.83 vs post 0.81, CI 0.73–0.98; P =.043) and conduit function (LA-SRe: pre 0.74, CI 0.67–0.99 vs post 0.89, CI 0.82–1.07; P =.025). LA volume index improved significantly with the Lariat (pre 35.4, CI 29.4–37.2 vs post 29.2, CI 28.2–35.9; P <.023). Conclusion: LAA exclusion seems to improve mechanical function of the LA and results in reverse LA remodeling.",
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T1 - Mechanical function of the left atrium is improved with epicardial ligation of the left atrial appendage

T2 - Insights from the LAFIT-LARIAT Registry

AU - Dar, Tawseef

AU - Afzal, Muhammad R.

AU - Yarlagadda, Bharath

AU - Kutty, Shelby

AU - Shang, Quanliang

AU - Gunda, Sampath

AU - Samanta, Anweshan

AU - Thummaluru, Jahnavi

AU - Arukala, Kedareeshwar S.

AU - Kanmanthareddy, Arun

AU - Reddy, Madhu

AU - Atkins, Donita

AU - Bommana, Sudharani

AU - Dawn, Buddhadeb

AU - Lakkireddy, Dhanunjaya

PY - 2018/7/1

Y1 - 2018/7/1

N2 - Background: Left atrial (LA) strain (ε) and ε rate (SR) analysis by 2-dimensional speckle tracking echocardiography is a novel method for functional assessment of the LA. Objective: The purpose of this study was to determine the impact of left atrial appendage (LAA) exclusion by Lariat epicardial ligation on mechanical function of the LA by performing ε and SR analysis before and after the procedure. Methods: A total of 66 patients who underwent successful LAA exclusion were included in the study. Of these 66 patients, 32 had adequate paired data for ε and SR analysis. SR during ventricular systole (LA-SRs) represents LA reservoir function, and SR during early ventricular diastole (LA-SRe) represents LA conduit function. ε and SR were determined from apical 4- and 2-chamber views using the electrocardiographic QRS as a reference point. LA volume index as surrogate for LA remodeling was measured from apical views. Results: Mean patient age was 70 ± 9.2 years. LAA ligation resulted in improved reservoir function (LA-SRs: pre 0.72, confidence interval [CI] 0.63–0.83 vs post 0.81, CI 0.73–0.98; P =.043) and conduit function (LA-SRe: pre 0.74, CI 0.67–0.99 vs post 0.89, CI 0.82–1.07; P =.025). LA volume index improved significantly with the Lariat (pre 35.4, CI 29.4–37.2 vs post 29.2, CI 28.2–35.9; P <.023). Conclusion: LAA exclusion seems to improve mechanical function of the LA and results in reverse LA remodeling.

AB - Background: Left atrial (LA) strain (ε) and ε rate (SR) analysis by 2-dimensional speckle tracking echocardiography is a novel method for functional assessment of the LA. Objective: The purpose of this study was to determine the impact of left atrial appendage (LAA) exclusion by Lariat epicardial ligation on mechanical function of the LA by performing ε and SR analysis before and after the procedure. Methods: A total of 66 patients who underwent successful LAA exclusion were included in the study. Of these 66 patients, 32 had adequate paired data for ε and SR analysis. SR during ventricular systole (LA-SRs) represents LA reservoir function, and SR during early ventricular diastole (LA-SRe) represents LA conduit function. ε and SR were determined from apical 4- and 2-chamber views using the electrocardiographic QRS as a reference point. LA volume index as surrogate for LA remodeling was measured from apical views. Results: Mean patient age was 70 ± 9.2 years. LAA ligation resulted in improved reservoir function (LA-SRs: pre 0.72, confidence interval [CI] 0.63–0.83 vs post 0.81, CI 0.73–0.98; P =.043) and conduit function (LA-SRe: pre 0.74, CI 0.67–0.99 vs post 0.89, CI 0.82–1.07; P =.025). LA volume index improved significantly with the Lariat (pre 35.4, CI 29.4–37.2 vs post 29.2, CI 28.2–35.9; P <.023). Conclusion: LAA exclusion seems to improve mechanical function of the LA and results in reverse LA remodeling.

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KW - Remodeling

KW - Speckle tracking echocardiography

KW - Strain analysis

KW - Suture exclusion

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