Ask an Expert

Please enter your login and password here



Please enter your login and password here


Journal Scan

Left atrial appendage electrical isolation and concomitant device occlusion: A safety and feasibility study withhistologic characterization.

Heart Rhythm. 2015 Jan;12(1):202-10.

Left atrial appendage electrical isolation and concomitant device occlusion: A safety and feasibility study withhistologic characterization.

Panikker S1Virmani R2Sakakura K2Kolodgie F2Francis DP1Markides V1Walcott G3McElderry HT3Wong T4.


Left atrial appendage (LAA) electrical isolation is reported to improve atrial fibrillation ablation outcomes. However, loss of mechanical function may increase thromboembolic risk.


The aim of this study was to evaluate the feasibility and safety of LAA occlusion after electrical isolation in a canine model.


Nine canines underwent LAA isolation with irrigated radiofrequency ablation after pulmonary vein (PV) isolation. Entrance and exit block were confirmed with intravenous adenosine after 30 minutes. The LAA was then occluded with a Watchman device. Device position was assessed at 10 days by using transthoracic echocardiography. At 45 days, LAA isolation was assessed epicardially. Hearts were then examined macroscopically and histologically.


All 36 PVs and 8 of 9 LAAs (89%) were electrically isolated. Acute LAA reconnection occurred in 4 of 8 LAAs (50%). All were reisolated. The mean ablation time was 51 ± 19 minutes, including 24 ± 18 minutes for LAA isolation. LAA occlusion was successful in all cases. One animal died of a primary intracranial bleed due to anticoagulant hypersensitivity 36 hours after the procedure. Transthoracic echocardiography at 10 days confirmed satisfactory device positions and no pericardial effusion. At 45 days, 7 of 8 (88%) had persistent LAA electrical isolation. All devices were stable without evidence of erosion. Microscopy revealed complete device-tissue apposition and a mature connective tissue layer overlying thedevice surface in all cases.


LAA electrical isolation and mechanical occlusion can be performed concomitantly in this animal model, with no displacement or mechanical erosion of the appendage at 45 days. This technique can potentially improve success rates and obviate the need for chronic anticoagulation. Future studies should address efficacy, safety, and feasibility in humans.



  • Members - Full time life members with voting rights: All those with DM/DNB cardiology qualification or equivalent and interest in arrhythmia/EP : Fees Rs 10,000.
  • Associate Members - DM/DNB/Fellows during training period. Fees Rs 3,000. No voting rights.
  • International Members: Overseas doctors with appropriate qualification and interest in arrhythmias. No voting rights. Fees 300$.
  • Industry members: Industry personnel associated with arrhythmology can become members. Membership is non-transferable. No voting rights. Fees 25,0000.
  • Any Associate Members who become eligible for Full time life membership (on completion of training period), need to pay only the balance of Rs 7,000 (10,000 - 3,000) if this is one within 1 year after completion of training. If the application for Full time life membership is received after expiry of one year of their entry as Associate Members, the full fees (viz Rs 10,000) shall apply.
  • Membership application need to be endorsed by two IHRS Members.
  • The application forms received by the office of Secretary, IHRS would need to be finally approved by the credentialing Committee (comprising of President, Secretary and Joint Secretary, IHRS).

Please print this form and send appropriate DD/Cheque in favour of Indian Heart Rhythm Society, and send through post to the following Address:

Dr Anil Saxena
Director, Cardiac Pacing & Electrophysiology
Fortis Escorts Heart Institute
Okhla Road, New Delhi, 110025 INDIA
Secretary, Indian Heart Rhythm Society
Mobile: +91 9810025511
Secretary: +91 9910665566 (Ms Kumkum Sharma)