Severe orthostatic hypotension after left atrial appendage occlusion
Christopher Kopreski, Edward H Puckett, Antonio Sotolongo-Fernandez, Kent R Nilsson · 2026
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Description
Christopher Kopreski and three colleagues report in 2026 the first known case of severe dizziness-on-standing after implantation of a second-generation device that seals off the heart's left atrial appendage. The procedure prevents strokes in atrial fibrillation patients who cannot take blood thinners. A seventy-year-old man with intermittent fibrillation and a history of falls received the Amulet device because anticoagulation was unsafe for him.
Within hours he developed severe orthostatic hypotension, a sharp blood pressure drop on standing, despite correct device placement. The authors suspect hormone shifts after appendage closure, since the tissue normally releases a peptide that promotes fluid loss, compounded by his other pressure-lowering medicines. Fluids, medication adjustments, and drug treatment for the low pressure resolved his symptoms over time without removing the device, a gentler ending than the only earlier published case.
Catalog record
| CREATOR | Christopher Kopreski, Edward H Puckett, Antonio Sotolongo-Fernandez, Kent R Nilsson |
|---|---|
| YEAR | 2026 |
| COLLECTION | PAPERS |
| FORMAT | TXT |
| FILE SIZE | 14722 |
| LICENSE | https://creativecommons.org/licenses/by/4.0 |
| RIGHTS | CC BY |
| SOURCE | Europe PMC |