Device-Related Thrombosis After Percutaneous Left Atrial Appendage Occlusion for Atrial Fibrillation

Area of Science:

• Cardiology
• Interventional Cardiology
• Medical Devices

Background:

• Transcatheter left atrial appendage (LAA) occlusion offers an alternative stroke prevention strategy for patients with atrial fibrillation (AF).
• Understanding the risks associated with LAA closure devices is crucial for patient management.

Purpose of the Study:

• To determine the incidence of thrombus formation on LAA closure devices in patients with AF.
• To identify predictors of device-related thrombus.
• To assess the prognostic impact of thrombus on stroke risk.

Main Methods:

• Retrospective analysis of 469 patients undergoing LAA closure with Watchman or Amplatzer devices across 8 French centers (2012-2017).
• Evaluation of LAA imaging, adverse events, and clinical outcomes during a mean follow-up of 13 months.

Main Results:

• The incidence of device-related thrombus was 7.2% per year among patients with LAA imaging.
• Older age and history of stroke were predictors of thrombus formation.
• Dual antiplatelet therapy and oral anticoagulation at discharge were protective.
• Device-related thrombus and vascular disease independently predicted ischemic strokes and transient ischemic attacks.

Conclusions:

• Thrombus formation on LAA closure devices is a significant concern in AF patients.
• Device-related thrombus is associated with an increased risk of ischemic stroke during follow-up.