[Clinical analysis of left atrial appendage occlusion for stroke prevention in elderly patients with atrial...

Area of Science:

• Cardiology
• Interventional Cardiology
• Geriatric Medicine

Background:

• Atrial fibrillation (AF) significantly increases stroke risk, particularly in elderly patients.
• Left atrial appendage occlusion (LAAO) is an alternative to anticoagulation for stroke prevention in AF.
• Limited data exists on LAAO efficacy and safety specifically in patients over 75 years old.

Purpose of the Study:

• To evaluate the efficacy and safety of LAAO in patients with AF aged over 75 years.
• To compare perioperative complications and long-term outcomes (ischemic stroke, major bleeding) between elderly ( >75 years) and younger (≤75 years) AF patients undergoing LAAO.

Main Methods:

• Retrospective analysis of 82 AF patients who underwent successful LAAO.
• Patients were divided into an elderly group (>75 years) and a younger group (≤75 years).
• Perioperative risks and follow-up events including ischemic stroke and major bleeding were analyzed.

Main Results:

• No significant differences in perioperative ischemic stroke or major bleeding between groups.
• No deaths or pericardial tamponade occurred in either group.
• During follow-up (25.9±15.9 months), the elderly group had a stroke rate of 3.6/100 person-years and a major bleeding rate of 2.5/100 person-years; the younger group had rates of 4.9/100 person-years and 0/100 person-years, respectively. The elderly group showed a more profound relative risk reduction for stroke (32.0% vs. 25.0%).

Conclusions:

• LAAO demonstrates comparable safety and efficacy in elderly AF patients compared to younger counterparts.
• LAAO is a potentially suitable option for stroke prevention in elderly AF patients.
• While stroke risk reduction was greater in the elderly, major bleeding risk was higher, warranting careful consideration.