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Updated: May 5, 2026
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Left atrial appendage occlusion in octogenarians: short-term and 1-year follow-up
Sameer Gafoor1, Jennifer Franke, Stefan Bertog
1Cardiovascular Center, Frankfurt, Germany.
Insights
Left atrial appendage (LAA) occlusion is a safe and effective stroke prevention method for octogenarians with atrial fibrillation (AF). This procedure demonstrates high success and efficacy rates in very elderly patients unsuitable for anticoagulation.
Area of Science:
- Cardiology
- Medical Devices
- Geriatric Medicine
Background:
- Atrial fibrillation (AF) patients over 80 often have contraindications for anticoagulation.
- Left atrial appendage (LAA) occlusion offers an alternative stroke prevention strategy.
- Limited data exists on LAA occlusion safety and efficacy in the very elderly population.
Purpose of the Study:
- To evaluate the procedural safety and clinical efficacy of LAA occlusion in octogenarian patients.
- To assess the outcomes of LAA occlusion in individuals aged 80 and above with AF.
Main Methods:
- Retrospective review of LAA occlusion cases in patients 80+ years old (2002-2013).
- Collection of demographic, echocardiographic, procedural, and clinical follow-up data.
- Analysis of various LAA occlusion devices including WATCHMAN, ACP, PLAATO, Lariat, and Coherex.
Main Results:
- 75 patients (mean age 83.4 years) underwent attempted LAA occlusion.
- High rates of comorbidities including hypertension (96%), coronary artery disease (41.3%), and heart failure (36%).
- Procedural success was 90.1%, safety endpoint at 3.9%, and 1-year device efficacy at 97.4%.
Conclusions:
- Left atrial appendage (LAA) closure is a safe and effective stroke prevention strategy for octogenarians with atrial fibrillation.
- The procedure demonstrates favorable safety and efficacy profiles in the very elderly population.
- LAA occlusion is a viable option for stroke risk reduction in elderly AF patients with contraindications to anticoagulation.
Objectives:
To determine the procedural safety, safety, and efficacy of left atrial appendage (LAA) occlusion in octogenarians.
Background:
Elderly patients with atrial fibrillation (AF) often do not receive appropriate anticoagulation. LAA occlusion is an option for patients with AF and contraindications to anticoagulation. Not much is known about the procedural safety and clinical efficacy of LAA occlusion in the very elderly.
Methods:
A retrospective review of LAA cases at our institution between 2002 and 2013 in patients 80 years of age or older was performed. Demographic, echocardiographic, procedural, and clinical follow-up data were collected.
Results:
Seventy-five cases were attempted in patients 80 years of age or older (average age 83.4 ± 2.8 years, 53.3% males). Hypertension, coronary artery disease, and heart failure were present in 96, 41.3, and 36%, respectively. Mean CHADS2 and CHA2DS-VASc scores were 3.3 and 5.2. Devices used included the WATCHMAN, ACP, PLAATO, Lariat, and Coherex devices, which were attempted in 34.7, 36, 17.3, 5.3, and 5.3%, respectively. Overall procedural success, safety endpoint, and 1-year device efficacy was 90.1, 3.9, and 97.4%, respectively.
Conclusion:
LAA closure is a safe and efficacious method of stroke prevention in the very elderly with AF.
