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Updated: May 11, 2026
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Left atrial appendage occlusion: single center experience with PLAATO LAA Occlusion System(®) and AMPLATZER™ Cardiac
Frederik Helsen1, Dieter Nuyens, Pieter De Meester
1Department of Cardiology, University Hospitals Leuven, Leuven, Belgium. frederik.helsen@uzleuven.be
Insights
Percutaneous left atrial appendage (LAA) closure is a safe and feasible alternative for patients with atrial fibrillation (AF) who cannot take oral anticoagulants. This procedure showed a reduced risk of stroke events during midterm follow-up.
Area of Science:
- Cardiology
- Interventional Cardiology
- Electrophysiology
Background:
- Oral anticoagulants (OAC) are standard for stroke prevention in atrial fibrillation (AF).
- The left atrial appendage (LAA) is a primary source of AF-related thrombi.
- LAA occlusion is a potential strategy to mitigate thromboembolic (TE) risk and is now included in ESC guidelines for AF management.
Purpose of the Study:
- To assess patient selection criteria for percutaneous LAA occlusion.
- To evaluate the safety and feasibility of LAA occlusion.
- To determine the midterm outcomes of LAA occlusion procedures.
Main Methods:
- Retrospective analysis of percutaneous LAA closures performed between September 2003 and September 2011 at a single center.
- Inclusion of 25 patients with a median age of 73 years, high CHA2DS2-VASc (median 5) and HAS-BLED (median 4) scores.
- Primary indication for LAA closure was intracranial hemorrhage during OAC therapy (52% of cases).
Main Results:
- Successful device implantation was achieved in 96% of patients.
- Over 60.6 patient-years of follow-up, the TE stroke event rate was 4.95 per 100 patient-years, compared to expected rates of 8.78 without OAC and 2.90 with OAC.
- No peripheral embolism events were observed, and major procedure-related adverse events occurred in only two patients.
Conclusions:
- Percutaneous LAA closure is a feasible and safe interventional procedure.
- LAA closure is particularly indicated for patients with contraindications to OAC, such as a history of intracranial hemorrhage.
- The study demonstrated a low rate of TE stroke events, supporting LAA closure as a viable alternative stroke prevention strategy in select AF patients.
Objectives:
To evaluate patient selection, safety, feasibility, and midterm results of percutaneous left atrial appendage (LAA) occlusion.
Background:
Oral anticoagulants (OAC) are the gold standard for stroke prevention in most patients with atrial fibrillation (AF). As the LAA is the main source of AF-related thrombi, LAA occlusion might reduce the thromboembolic (TE) risk. Recently, LAA closure was implemented in the European Society of Cardiology guidelines for the management of AF.
Methods:
This retrospective single center study examined all LAA percutaneous closures (September 2003-September 2011).
Results:
Twenty-five patients were included in the study; median age at closure was 73 years (minimum maximum range 49-85 years), 68% men. Median CHA2DS2-VASc score and HAS-BLED score were 5 (IQR 4-6) and 4 (IQR 4-5), respectively. Most frequent reason for LAA closure was intracranial hemorrhage during OAC treatment (52%). Successful device implantation was achieved in 96%. During a follow-up of 60.6 patient years, the TE stroke event rate was 4.95 per 100 patient years, versus an expected rate of 8.78 and 2.90 without and with OAC, respectively. No peripheral embolism occurred. Major procedure-related adverse events occurred in two patients.
Conclusions:
Percutaneous closure of the LAA is feasible and safe. Intracranial hemorrhage was the most important indication for LAA closure. A low number of TE stroke events occurred during follow-up. LAA closure might be a good alternative in patients with a firm contraindication for OAC.
