Related Experiment Video
Updated: May 4, 2026
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Interventional closure of the left atrial appendage for stroke prevention
Yae Matsuo1, Marcus Sandri, Norman Mangner
1Department of Cardiology, University Leipzig-Heart Center Leipzig.
Insights
Transcatheter left atrial appendage (LAA) closure is a safe and effective stroke prevention method for atrial fibrillation (AF) patients. Real-world data show high success rates and low complication risks, allowing safe discontinuation of oral anticoagulation.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Devices
Background:
- Transcatheter left atrial appendage (LAA) closure offers an alternative stroke prevention strategy for patients with atrial fibrillation (AF).
- Limited real-world data exist on the efficacy, safety, and complications of LAA closure in routine clinical practice.
- This study aimed to evaluate procedural outcomes and complications of LAA closure at a high-volume center.
Purpose of the Study:
- To assess the real-world efficacy and safety of transcatheter LAA closure.
- To determine the procedural outcomes and complication rates in routine clinical practice.
- To evaluate the safety of discontinuing oral anticoagulation after LAA closure.
Main Methods:
- A retrospective analysis of 179 patients with AF undergoing LAA closure at a single high-volume center in Germany.
- Data collected on implantation success rates, procedure-related complications (major and minor), and short-term outcomes.
- Follow-up at 45 days and 6 months to assess LAA sealing, oral anticoagulation (OAC) status, and clinical events.
Main Results:
- Successful LAA closure was achieved in 98.9% of patients.
- The overall procedure-related complication rate was 11.2% (major: 3.3%, minor: 7.8%).
- At 45 days, 99.4% had successful LAA sealing, and 94.5% discontinued OAC. No strokes were reported during 6-month follow-up, with rare major complications.
Conclusions:
- Transcatheter LAA closure is a safe and feasible procedure in a high-volume setting.
- Life-threatening complications associated with LAA closure are infrequent.
- Discontinuation of OAC 45 days post-implantation is safe for AF patients undergoing LAA closure.
Background:
Transcatheter left atrial appendage (LAA) closure is an alternative therapy for stroke prevention in atrial fibrillation (AF) patients. However; real-world efficacy, safety and complications have yet to be investigated. We sought to determine the procedural outcomes and potential complications of LAA closure in routine clinical practice at a high-volume center.
Methods And Results:
The study group comprised 179 patients (105 males; 72.7±9.0 years) with AF undergoing LAA closure at a single center in Germany. The rate of successful implantation was 98.9% (2 patients did not undergo implantation) and the overall procedure-related complication rate was 11.2% (major: 3.3%: tamponade 2; possibility of transient ischemic attack (TIA) 1; device dislocation 3; minor: 7.8%: pericardial effusion 2; air embolization with transient ST segment elevation 3; thrombus on device/sheath 3; puncture complications 5). At 45 days; 99.4% showed successful sealing of the LAA and 94.5% discontinued oral anticoagulation (OAC). TIA occurred in 2 patients during 6-month follow-up; but no cases of stroke were reported. There were no hemorrhagic stroke or device-related deaths. Only 1 patient was hospitalized with traumatic subdural hematoma. Minor bleeding was reported in 5 patients.
Conclusions:
Transcatheter LAA closure in a high-volume center is safe and feasible. Life-threatening complications are rare. Discontinuation of OAC 45 days after implantation was also safe.
