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Updated: Oct 25, 2025
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Length of stay following percutaneous left atrial appendage occlusion: Data from the prospective, multicenter
Kerstin Piayda1, Shazia Afzal1, Jens Erik Nielsen-Kudsk2
1Medical Faculty, Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
Insights
Over half of patients undergoing left atrial appendage occlusion (LAAO) with the Amplatzer Amulet device go home the same or next day. Serious adverse events and a higher HAS-BLED score significantly increase the risk of a prolonged hospital stay.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Devices
Background:
- Percutaneous left atrial appendage occlusion (LAAO) is an alternative to anticoagulation for stroke prevention in atrial fibrillation.
- Optimizing patient discharge after LAAO is crucial for resource management and patient satisfaction.
Purpose of the Study:
- To identify factors influencing hospital length of stay (LOS) following percutaneous LAAO.
- To analyze the impact of serious adverse events (SAEs) and patient characteristics on discharge timing.
Main Methods:
- Analysis of data from the Amplatzer Amulet Occluder Observational Study.
- Categorization of patients into same-day, early (1-day), regular (2-3 days), and late (≥4 days) discharge groups.
- Multinomial logistic regression to identify independent predictors of late discharge.
Main Results:
- Over half of patients (54.5%) were discharged within 1 day.
- Procedure and device-related SAEs were significantly associated with prolonged LOS (p<0.0001).
- Higher HAS-BLED score was the only independent predictor of late discharge (p=0.04).
Conclusions:
- Most patients undergoing LAAO with the Amplatzer Amulet device experience short hospital stays.
- SAEs are a primary driver of extended LOS, highlighting the importance of procedural safety.
- HAS-BLED score can help identify patients at risk for prolonged hospitalization after LAAO.
Aims:
To evaluate factors influencing the length of stay in patients undergoing percutaneous left atrial appendage occlusion (LAAO).
Methods And Results:
Patient characteristics, procedural data and the occurrence of serious adverse events were analyzed from the AmplatzerTM AmuletTM Occluder Observational Study. Patients were divided into three groups: same day (S, 0day, n = 60, 5.6%) early (E, 1day, n = 526, 48.9%), regular (R, 2-3days, n = 338, 31.4%) and late (L, ≥4days, n = 152, 14.1%) discharge and followed up for 60 days. Procedure and device related SAE during the in-hospital stay (S: 0.0% vs. E: 1.0% vs. R: 2.1% vs. L: 23%, p<0.0001) were a major trigger for a prolonged in-hospital stay. Of the 37 subjects in the late discharge group with an SAE prior to discharge, cardiac or bleeding complications were the most common underlying conditions, occurring in 26 subjects. Multinomial logistic analysis only identified HAS-BLED score as an independent influencing factor (p = 0.04) for a late discharge. After 60 days, mortality tended to be greatest in the late discharge group (S: 0.0% vs. E: 1.0% vs. R: 1.2% vs. L: 3.3%, p = 0.1066).
Conclusion:
Over half of the subjects receiving an Amplatzer Amulet occluder were discharged within 1 day of the implant procedure. Serious adverse events were a major trigger for a late discharge after LAAO. Increased HAS-BLED score was associated with a prolonged in-hospital stay.
