Decennial Analysis of Interventional Left Atrial Appendage Closure

Area of Science:

• Cardiology
• Interventional Cardiology
• Electrophysiology

Background:

• Limited long-term follow-up (LTFU) data exists for interventional left atrial appendage closure (LAAC) in nonvalvular atrial fibrillation (AF) patients.
• Assessing outcomes with first-generation LAAC devices is crucial for understanding long-term safety and efficacy.

Purpose of the Study:

• To evaluate the long-term outcomes of patients undergoing LAAC using a first-generation device.
• To determine the rates of thrombotic and bleeding complications after LAAC in a nonvalvular AF population.

Main Methods:

• Analysis of the Cardioangiologisches Centrum Bethanien (CCB) LAAC registry database.
• Inclusion of 45 AF patients who received LAAC between October 2001 and July 2007.
• Post-implant dual-platelet inhibition followed by aspirin indefinitely; median follow-up of 7.4 years.

Main Results:

• The observed annual stroke rate was 1.7% (RR 0.43, P = 0.0028), and the annual bleeding rate was 2.1% (RR 0.56, P < 0.0001).
• No deaths were attributed to stroke or bleeding complications.
• Fourteen patients died, primarily from heart failure or non-cardiac causes.

Conclusions:

• LAAC with first-generation devices in nonvalvular AF patients is associated with lower-than-expected rates of thrombotic and bleeding complications during long-term follow-up.
• These findings support the safety and efficacy of LAAC for stroke risk reduction in AF patients.