{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T03:06:10Z","timestamp":1786590370867,"version":"build-2736575974"},"reference-count":45,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2015,4,29]],"date-time":"2015-04-29T00:00:00Z","timestamp":1430265600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2015,6]]},"abstract":"<jats:title>LAA Ligation and Pulmonary Vein Isolation<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Left atrial appendage (LAA) ligation results in LAA electrical isolation and a decrease in atrial fibrillation (AF) burden. This study assessed the feasibility of combined percutaneous LAA ligation and pulmonary vein isolation (PVI) in patients with persistent AF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>A total of 22 patients with persistent AF underwent LAA ligation with the LARIAT device followed by PVI. PVI was confirmed with the demonstration of both entrance and exit block. Patients (n = 10) in sinus rhythm pre\u2010 and post\u2010LAA ligation underwent P\u2010wave analysis. Monitoring for AF was performed at 1, 3, and 6 months postablation.<\/jats:p><jats:p>LAA ligation was successful in 21 of 22 (95%) patients. The procedure was aborted in one patient due to pericardial adhesions. PVI was performed in 20 of 21 patients. One patient converted to atrial flutter with a controlled ventricular response after LAA ligation and refused subsequent PVI. Demonstration of entrance and exit block was achieved in 19 of 20 patients. At 3 months, 13 of 19 (68.4%) patients were in sinus rhythm. Four patients underwent a second PVI. At 6 months, 15 of 20 (75%) patients were in sinus rhythm. There was a significant decrease in P\u2010wave duration and P\u2010wave dispersion after LAA ligation. Complications with LAA ligation included pericarditis, a delayed pleural effusion, and a late pericardial effusion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Staged LAA ligation and PVI is feasible and decreases P\u2010wave dispersion. Randomized studies are needed to assess the efficacy of LAA ligation as adjunctive therapy to PVI for maintaining sinus rhythm in patients with persistent AF.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.12655","type":"journal-article","created":{"date-parts":[[2015,3,14]],"date-time":"2015-03-14T07:45:32Z","timestamp":1426319132000},"page":"608-614","source":"Crossref","is-referenced-by-count":29,"title":["Sequential Percutaneous LAA Ligation and Pulmonary Vein Isolation in Patients with Persistent AF: Initial Results of a Feasibility Study"],"prefix":"10.1111","volume":"26","author":[{"given":"NITISH","family":"BADHWAR","sequence":"first","affiliation":[{"name":"Section of Cardiac Electrophysiology Division of Cardiology University of California, San Francisco  San Francisco California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"DHANUNJAYA","family":"LAKKIREDDY","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of Kansas Medical Center  Kansas City Kansas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MITSUHARU","family":"KAWAMURA","sequence":"additional","affiliation":[{"name":"Section of Cardiac Electrophysiology Division of Cardiology University of California, San Francisco  San Francisco California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"FREDERICK T.","family":"HAN","sequence":"additional","affiliation":[{"name":"University of Utah Health Sciences Center  Salt Lake City Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"SIVARAMAN K.","family":"IYER","sequence":"additional","affiliation":[{"name":"Section of Cardiac Electrophysiology Division of Cardiology University of California, San Francisco  San Francisco California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"BRIAN S.","family":"MOYERS","sequence":"additional","affiliation":[{"name":"Section of Cardiac Electrophysiology Division of Cardiology University of California, San Francisco  San Francisco California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"THOMAS A.","family":"DEWLAND","sequence":"additional","affiliation":[{"name":"Section of Cardiac Electrophysiology Division of Cardiology University of California, San Francisco  San Francisco California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"CHRIS","family":"WOODS","sequence":"additional","affiliation":[{"name":"Section of Cardiac Electrophysiology Division of Cardiology University of California, San Francisco  San Francisco California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"RYAN","family":"FERRELL","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of Kansas Medical Center  Kansas City Kansas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JAYANT","family":"NATH","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of Kansas Medical Center  Kansas City Kansas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MATHEW","family":"EARNEST","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of Kansas Medical Center  Kansas City Kansas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"RANDALL J.","family":"LEE","sequence":"additional","affiliation":[{"name":"Section of Cardiac Electrophysiology Division of Cardiology University of California, San Francisco  San Francisco California"},{"name":"Cardiovascular Research Institute at the University of California  San Francisco California"},{"name":"Institute for Regeneration Medicine at the University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,4,29]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.04.060"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)36685-1"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.111.963819"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.928903"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2011.07.013"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.074047"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2014.01.019"},{"key":"e_1_2_7_9_1","first-page":"52","volume":"12","author":"Afzal MR","year":"2015","journal-title":"Impact of left atrial appendage exclusion using an epicardial ligation system (LARIAT) on atrial fibrillation burden in patients with cardiac implantable electronic devices. 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