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Updated: Nov 29, 2025

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
28:13

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Published on: February 26, 2013

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Comorbidity burden in patients undergoing left atrial appendage closure

Shubrandu Sanjoy1, Yun-Hee Choi1, David Holmes2

  • 1Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.

Heart (British Cardiac Society)
|November 24, 2020
PubMed

Insights

Patients undergoing left atrial appendage closure (LAAC) with higher comorbidity burden face increased in-hospital major adverse events (MAE). This study highlights that female sex, non-white race, and elevated comorbidity scores are associated with higher MAE risks post-LAAC.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Health Services Research

Background:

  • Left atrial appendage closure (LAAC) is an alternative to anticoagulation for stroke prevention in atrial fibrillation.
  • Patient populations undergoing LAAC often have significant comorbidities, influencing procedural outcomes.
  • Understanding the relationship between comorbidity burden and in-hospital complications is crucial for risk stratification and patient selection.

Purpose of the Study:

  • To evaluate the association between comorbidity burden and the risk of in-hospital major adverse events (MAE) following LAAC.
  • To identify patient subgroups at higher risk for complications after LAAC.
  • To inform clinical decision-making and improve patient safety in LAAC procedures.

Main Methods:

  • A cohort-based observational study utilizing the US National Inpatient Sample database (October 2015 - December 2017).
  • In-hospital MAE, defined as a composite of bleeding, acute kidney injury, vascular, cardiac complications, and stroke, was the primary outcome.
  • Comorbidity burden and thromboembolic risk were assessed using Charlson Comorbidity Index (CCI), Elixhauser Comorbidity Score (ECS), and CHA₂DS₂-VASc score. Logistic regression models were employed for analysis.

Main Results:

  • A total of 3294 hospitalizations were analyzed, with a mean patient age of 75.7 years; 60% were male and 86% were white.
  • The overall in-hospital MAE rate was 4.6%.
  • Higher CCI (aOR: 1.19), ECS (aOR: 1.06), and CHA₂DS₂-VASc scores (aOR: 1.08) were significantly associated with increased MAE risk. Females and non-white patients also had approximately 1.5 times higher odds of MAE.

Conclusions:

  • The majority of patients undergoing LAAC have a substantial comorbidity burden.
  • In-hospital MAE occurred in 4.6% of LAAC procedures.
  • Female sex, non-white race, and a higher comorbidity burden are significant risk factors for in-hospital MAE after LAAC.
Abstract

Keywords:
atrial arrhythmia ablation procedureselectrophysiologyepidemiologystroke

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