COCONUTPulse Field Ablation and Left Atrial Appendage Closure for Atrial Fibrillation

The COCONUT study focuses on a combined approach to treat atrial fibrillation (AF), a common heart rhythm disorder. This approach involves two procedures: pulmonary vein isolation (PVI) using a novel ablation method called pulsed field ablation (PFA), and left atrial appendage closure (LAAC). These procedures are typically performed separately, but the study aims to investigate the benefits of performing them together. The study targets patients with non-valvular AF who are at high risk for stroke and cannot take long-term oral anticoagulation. The potential benefits include shorter procedure times, increased safety, and improved patient outcomes. In this worldwide, retrospective, multicenter registry study, participants undergo both PVI using the Farapulse PFA system and LAAC with the WATCHMAN Flx device. The study evaluates the safety, efficacy, and efficiency of this combined approach. The primary outcomes measured include the maintenance of a normal heart rhythm (sinus rhythm) one year after the procedure, and the rate of complications during and after the procedure, such as pericardial tamponade, pericardial effusion, and venous access site hematoma. The study also explores potential benefits such as reducing the need for oral anticoagulation therapy and decreasing periprocedural complications, as well as economic benefits from a single hospital stay instead of two.