Authors

• Ante Anić — Zadar General Hospital, Zadar, Croatia — ORCID: 0000-0002-6864-3999
• Zorislav Šušak — Zadar General Hospital, Zadar, Croatia — ORCID: 0000-0003-2977-6833
• Branimir Bukša — Zadar General Hospital, Zadar, Croatia — ORCID: 0000-0001-5206-512X
• Iva Pavić — Zadar General Hospital, Zadar, Croatia — ORCID: 0000-0002-2410-3050
• Barbara Petani — Zadar General Hospital, Zadar, Croatia — ORCID: 0000-0002-1509-755X

Keywords

atrial fibrillation, atrial function, catheter ablation, embolism

DOI

Full Text

**Introduction:** Percutaneous left atrial appendage (LAA) occlusion is a valuable option for stroke and systemic embolism (SSE) prevention in patients with atrial fibrillation (AF) that do not tolerate anticoagulant therapy. (1) Amplatzer Amulet is one of devices available that predominates as a device of choice across European centers **Methods:** This is an overview of indications, some intraprocedural aspects and postprocedural management of 6 patients in whom we implanted LAA occluder (Amplatzer Amulet) from July 2016 till October 2016 in Zadar General Hospital. **Results:** All patients had CHA2DS2 VASC score of ≥3 and had a history of major bleeding under anticoagulant therapy (gastrointestinal in 5 patients, urinary tract bleeding in 1). Preprocedural MSCT left atrial angiography was performed to give insight in LAA anatomy and device landing zone dimensions. Procedures were performed in general anesthesia. Devices size implanted varied from 22-31 mm. No intra or postprocedural complication occurred. All patients were discharged with dual antiplatelet therapy. No device embolization in early follow up had been documented and at 3 months follow up all devices retained their original position and conformation. **Conclusion:** LAA occluder implantation is a rather safe procedure that serves as a good alternative for SSE prevention in patients with AF and at high risk for SSE and who do not tolerate anticoagulant therapy. Amplatzer Amulet device offers biggest size range thus virtually being able to occlude any type of appendage.

Literature

1. Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B, et al. Authors/Task Force Members; Document Reviewers. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS: The Task Force for the management of atrial fibrillation of the European Society of Cardiology (ESC)Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESCEndorsed by the European Stroke Organisation (ESO). Europace. 2016 Aug 27;•••:euw295.; Epub ahead of print. https://doi.org/10.1093/europace/euw295