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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

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Left atrial appendage occlusion in atrial fibrillation after intracranial hemorrhage

Solveig Horstmann1, Christian Zugck, Ulrike Krumsdorf

  • 1From the Department of Neurology (S.H., T.R., R.V.), Department of Cardiology (C.Z., U.K., N.G., S.H.), and Institute of Medical Biometry and Informatics (G.R.), University of Heidelberg, Germany.

Neurology
|December 10, 2013
PubMed

Insights

Percutaneous left atrial appendage occlusion (LAAO) is a safe and feasible procedure for patients with atrial fibrillation and prior intracranial hemorrhage. This study found no major complications or strokes during follow-up.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Neurology

Background:

  • Patients with atrial fibrillation (AF) and a history of intracranial hemorrhage (ICH) face a high risk of stroke and bleeding.
  • Anticoagulant therapy, often used for stroke prevention in AF, increases the risk of ICH.
  • Left atrial appendage occlusion (LAAO) offers an alternative stroke prevention strategy.

Purpose of the Study:

  • To assess the safety and feasibility of percutaneous LAAO in patients with AF and a history of ICH.
  • To evaluate the incidence of major periprocedural complications and long-term clinical outcomes.

Main Methods:

  • An observational, prospective, single-center study involving 20 patients with AF and prior ICH.
  • LAAO was performed using the Amplatzer Cardiac Plug device.
  • Patients were monitored for clinical status and complications at regular intervals post-procedure.

Main Results:

  • LAAO was successfully performed in all 20 patients without any procedure-related major complications.
  • Minor complications included inguinal hematoma, self-limiting asystole, and device-related thrombus formation.
  • No ischemic or hemorrhagic strokes occurred during a mean follow-up of 13.6 months.

Conclusions:

  • Percutaneous LAAO is a safe and feasible option for stroke prevention in patients with AF and a history of ICH.
  • Further investigation in larger, controlled trials is warranted to confirm efficacy and safety compared to other methods.
Abstract

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