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Updated: Oct 23, 2025
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Analysis of outcome of 6-month readmissions after percutaneous left atrial appendage occlusion
Sae Morita1, Aaqib H Malik2, Toshiki Kuno3
1Department of Cardiology, Columbia University Medical Center, New York, New York, USA abriasoulis@med.uoa.gr.
Insights
Over a quarter of patients undergoing percutaneous left atrial appendage occlusion (LAAO) required readmission within six months. Heart failure and gastrointestinal bleeding were the primary reasons for these rehospitalizations, highlighting areas for improved post-procedure care.
Area of Science:
- Cardiology
- Interventional Cardiology
- Health Services Research
Background:
- Percutaneous left atrial appendage occlusion (LAAO) offers an alternative to oral anticoagulation for preventing thromboembolic events in atrial fibrillation patients.
- Real-world data is crucial for understanding patient outcomes and healthcare utilization following LAAO procedures.
Purpose of the Study:
- To evaluate the causes and timing of hospital readmissions within six months after percutaneous LAAO.
- To identify patient characteristics and clinical factors associated with readmissions post-LAAO.
Main Methods:
- Retrospective cohort study utilizing the Nationwide Readmissions Database (USA).
- Analysis of 12,446 patients who underwent percutaneous LAAO between January 2016 and June 2018.
- Assessment of readmission rates, causes, and associated patient factors within a 6-month follow-up period.
Main Results:
- 28% of patients (3,477) were readmitted within six months post-LAAO.
- The most common causes for readmission were heart failure (13%) and gastrointestinal bleeding (12%).
- Factors associated with heart failure readmissions included prior heart failure, valvular heart disease, and chronic kidney disease. Gastrointestinal bleeding readmissions were linked to diabetes, chronic kidney disease, and prior anemia.
Conclusions:
- Nearly one-third of patients undergoing LAAO experienced readmission within six months.
- Heart failure and gastrointestinal bleeding represent significant drivers of readmission, necessitating targeted interventions.
- Identifying high-risk patients through pre-existing conditions can inform strategies to reduce post-LAAO rehospitalizations.
Objective:
Percutaneous left atrial appendage occlusion (LAAO) is an alternative strategy for prevention of thromboembolic events in patients with atrial fibrillation and unsuitable for long-term oral anticoagulation. The study aimed to evaluate the causes and timing of readmissions within 6 months following percutaneous LAAO in a real-world setting.
Methods:
We conducted a retrospective cohort study of percutaneous LAAO performed in the USA between January and June of 2016-2018 using the Nationwide Readmissions Database.
Results:
Overall, 12 446 patients who underwent LAAO were included in the analyses and 3477 patients (28%) were readmitted within 6 months following the interventions. Readmitted patients were more often women (p=0.001). The index hospitalisation was characterised by longer duration of hospital stay (p<0.001) and complicated with acute kidney injury (p<0.001) among readmitted patients compared with those without readmissions. Readmissions within 6 months following the index intervention were mainly due to heart failure (13%) and gastrointestinal bleeding (12%). Characteristics associated with readmissions due to heart failure included previously known heart failure (HR 2.39; 95% CI 1.70 to 3.37), valvular heart disease (HR 1.39; 95% CI 1.05 to 1.84) and chronic kidney disease (HR 1.42; 95% CI 1.03 to 1.94). Readmissions due to gastrointestinal bleeding were associated with diabetes mellitus (HR 1.78; 95% CI 1.25 to 2.53), chronic kidney disease (HR 1.86; 95% CI 1.23 to 2.81) and previous anaemia (HR 2.41; 95% CI 1.54 to 3.77).
Conclusions:
After percutaneous LAAO, over a quarter of the patients in the USA required rehospitalisation within 6 months, mainly due to heart failure and gastrointestinal bleeding.
