Occlutech Atrial Flow Regulator (AFR) leads to significant symptomatic improvement in young patient with restrictive cardiomyopathy


A patient in his early 50s was diagnosed with restrictive cardiomyopathy a few years ago and showed progressive symptoms.


In the last six months, two inpatient stays for intravenous diuretic therapy were necessary to treat a severe right- sided cardiac decompensation. During these periods, the patient had severe dyspnoea (NYHA IV). The reduced performance capacity had led to employment issues.

The treatment:

An interatrial shunt device (Occlutech Atrial Flow Regulator (AFR)) was planned. Consistent with the restrictive cardiomyopathy, the pulmonary arterial wedge pressure (PCWP) was significantly elevated at 18 mmHg at rest. Furthermore, this value was significantly higher than the mean right atrial pressure of 3 mmHg. Thus, all criteria for the implantation of the AFR were fulfilled.

According to the previous taken measurements the size of the Atrial Flow Regulator was chosen as AFR08M (8mm fenestration; 5mm height). TEE showed an optimal position with a continuous left-right shunt. After implantation, a reduction in left atrial pressure from the previous 18 to 11 mmHg was measured.

Follow up:

Three months later the patient reported a considerable improvement in physical performance (dyspnoea NYHA I-II). This had also prompted him to look for a new job. TEE showed a correct position of the shunt device with continuous left-to- right shunt. The shunt volume measured invasively in the right heart catheterization was 24%. The PCWP remained at 11 mmHg.


The implantation of an interatrial shunt device is a technically simple and safe therapy option that can achieve a rapid improvement in the clinical symptoms of patients with diastolic heart failure1
Mathias Lange

Dr. med. Mathias Lange, FESC

Managing Senior Physician of the Clinic for Cardiology (Med. Klinik I)

Head of the Department of Structural Heart Disease

Specialist in internal medicine and cardiology, intensive care medicine, emergency medicine, hypertensiologist DHL

Main areas of activity: Interventional cardiology / structural heart specialist

Head of the special outpatient clinic for pulmonary arterial hypertension

Klinikum Osnabrück GmbH

1. Paitazoglou, Christina et. al. (2021). One-year results of the first-in-man study investigating the Atrial-Flow-Regulator for left-atrial shunting in symptomatic heart failure patients: the PRELIEVE study. European journal of heart failure. 10.1002/ejhf.2119.

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