All patients refered for LAAPC with Amplatzer Cardiac Plug (ACP) and Watchman device were enrolled. Cardiac computed tomography (CT) for LA volume measurement and transthoracic echocardiography (TTE) for diastolic function assessment were performed at baseline and 3 months after LAAPC. An average of 3 consecutives measurements were performed for TTE parameters in all patients.
Sixty-three patients (mean age 73±9 years) were included. 38% (n=24) was in sinus rythm at baseline and 55% (n=35) in permanent AF. Patients in SR at baseline and permanent AF at 3 months were exclued (n=4, 7%). The mean CHA2DS2-VASc score was 4,3±1,3. The procedure was successful in all patients.There was no significant difference in the functionnal status (p=0,74) and BNP (155,6 ± 107 baseline vs 155±150,6 pg/ml at 3 months ; p=0,85). Left atrial volume excluding the LAA (14±55ml baseline vs 144±50 cm3 at 3 months; p=0,30) showed no significant change after 3 months in the overall population, neither in the SR (99,7 ± 19,1 baseline vs 103,8±21 cm3 at 3 months ; p=0,32) or the permanent AF groups (173,2±54 baseline vs 171,7±48,6 cm3 at 3 months ; p=0,59).MV peak E-wave (84,2 ± 22,7 ; 86,7±26 cm/s, p=0,62) and A-wave velocities (65,4±14,4 ; 68,5 ± 22,2 cm/s, p=0,66) did not differ between baseline and three months. E/E’ ratio was higher in the overall population and there was a trend to higher E/E’ ratio in the SR group.
There's no evidence for early LA remodeling after LAAPC. LV pressure loading might be slighlty more elevated after LAA closure suggesting the potential reservoir role of the LAA. Further studies are warranted to confirm these prelimary results.
The author hereby declares no conflict of interest