Combined catheter ablation and left @entity955 as a hybrid procedure for the treatment of XXXX .

@entity1 @entity64 @entity548 @entity2293 @entity955 @entity299 @entity943
AIMS: Left atrial appendage (LAA) is the source of thrombi in up to 90% of @entity1 with non-valvular @entity955 ( @entity955 ). Catheter ablation (CA) is an effective treatment for symptomatic @entity955 and, in selected cases, LAA occlusion devices have been introduced as an alternative to oral anticoagulants (OACs). The safety and feasibility of combining CA and percutaneous LAA closure (LAAC) are unknown. METHODS AND RESULTS: @entity1 with symptomatic drug-refractory @entity955 , CHADS2 score of >= 1, and CHA2DS2-VASc score >= 2 were included. Catheter ablation consisted in pulmonary vein isolation with or without roof line with radiofrequency and LAA was occluded with the Watchman or @entity299 ( @entity299 ) devices guided by angiography and transoesophageal echocardiography. A total of 35 @entity1 were included (71% male; 70 years). Median score was 3 on both CHA2DS2-VASc and HAS-BLED, 9% had prior @entity64 under OAC, and 48% had @entity548 complications. Successful CA and device implantation were achieved in 97% of cases. The Watchman device was used in 29 @entity1 and @entity299 in 6 @entity1 . Periprocedural complications included three cases of @entity2293 . At 3 months, all @entity1 met the criteria for successful sealing of the LAA. After a mean follow-up of 13 months (3-75), 78% of @entity1 were free of @entity943 recurrences and OAC was withheld in 97% of @entity1 . CONCLUSIONS: The combination of CA and percutaneous LAAC in a single procedure is technically feasible in @entity1 with symptomatic drug-refractory @entity955 , high risk of @entity64 , and contraindications to OACs, although it is associated with a significant risk of major complications.
