A collective European experience with left atrial appendage suture ligation using the LARIAT+ device

Area of Science:

• Cardiology
• Medical Devices
• Interventional Procedures

Background:

• Atrial fibrillation (AF) poses a risk of thromboembolism, particularly from the left atrial appendage (LAA).
• Oral anticoagulation (OAC) is standard but carries bleeding risks and is contraindicated in some patients.
• Percutaneous LAA exclusion offers an alternative strategy for stroke risk reduction in select AF patients.

Purpose of the Study:

• To evaluate the European collective experience with percutaneous LAA suture ligation using the LARIAT+ device.
• To assess the safety and efficacy of LAA closure in patients unsuitable for or intolerant to OAC.

Main Methods:

• A total of 141 patients with non-valvular AF underwent LAA ligation with the LARIAT+ device across seven European centers.
• Follow-up included clinical visits and transoesophageal echocardiography (TOE) to assess LAA closure and complications.
• Procedural success, adverse events, and long-term outcomes were meticulously recorded.

Main Results:

• LAA ligation was successfully completed in 138/141 patients (97.8%).
• Serious 30-day adverse events occurred in 2.8% of patients, including two device-related LAA perforations successfully managed by the device itself.
• Complete LAA closure was confirmed in 97.1% of patients by TOE, with only two instances of transient ischemic attack during follow-up.

Conclusions:

• The LARIAT+ device facilitates feasible percutaneous left atrial appendage exclusion.
• This initial European experience highlights the safety and efficacy of the LARIAT+ for LAA closure.
• Larger prospective studies with extended follow-up are recommended to further validate these findings.