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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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Safety and efficacy of catheter-based left atrial appendage closure in patients with contraindications for long-term

Adrian Seidel1, Abdul S Parwani2, Florian Krackhardt2

  • 1Department of Cardiology, Campus Virchow-Klinikum, Charité University of Medicine, Berlin, Germany - adrian.seidel@charite.de.

Minerva Cardioangiologica
|June 2, 2017
PubMed

Insights

Percutaneous left atrial appendage closure (LAAC) effectively prevents thromboembolisms in high-risk patients. However, major bleeding events occurred frequently, regardless of anticoagulation status post-procedure.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Medical Devices

Background:

  • Percutaneous left atrial appendage closure (LAAC) is an alternative for patients with non-rheumatic atrial fibrillation at high risk for stroke.
  • The optimal post-procedural antithrombotic therapy remains controversial.

Purpose of the Study:

  • To evaluate the efficacy and safety of LAAC in patients with non-rheumatic atrial fibrillation, high thromboembolic risk, and contraindications for long-term anticoagulation.

Main Methods:

  • A total of 118 patients underwent attempted LAAC between 2010-2015.
  • Successful device implantation was achieved in 95% of cases.
  • Patients received either anticoagulation or dual antiplatelet therapy (DAPT) post-procedure, with potential reduction based on follow-up imaging.

Main Results:

  • The procedural complication rate was 3.4%.
  • One transient ischemic attack (TIA) occurred during follow-up (0.6%/year).
  • Eleven major bleeding events (6.6%/year) were observed, occurring in patients on various antithrombotic regimens, including DAPT and aspirin alone.

Conclusions:

  • Catheter-based LAAC demonstrates high efficacy in preventing thromboembolic events.
  • Major bleeding complications are common following LAAC, irrespective of the antithrombotic strategy employed.
Abstract

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