Related Experiment Video
Updated: Oct 10, 2025
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Predictors of Subsequent Heart Failure After Left Atrial Appendage Closure
Dae-Young Kim1, Min Ji Kim1, Jiwon Seo1
1Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine.
Insights
Left atrial appendage occlusion (LAAO) can increase heart failure (HF) risk. Prior HF history, higher E/e
Area of Science:
- Cardiology
- Electrophysiology
- Heart Failure Research
Background:
- Left atrial appendage occlusion (LAAO) is crucial for stroke prevention in atrial fibrillation patients.
- LAAO may negatively impact left atrial compliance and reservoir function, potentially increasing heart failure (HF) risk.
Purpose of the Study:
- To identify predictors of subsequent heart failure (HF) following successful left atrial appendage occlusion (LAAO).
Main Methods:
- Analysis of 98 patients who underwent LAAO, with a primary endpoint of unexpected HF admission.
- Multivariate analysis to identify independent predictors of HF admission.
- Comparison of HF incidence in LAAO patients versus a propensity score-matched control group.
Main Results:
- 16% of patients experienced hospital HF admission during a mean follow-up of 36 months.
- Higher E/e', increased left ventricular mass index, prior HF history, and lower left atrial strain were independently associated with HF admission.
- LAAO patients showed a significantly higher incidence of subsequent HF compared to controls.
Conclusions:
- Left atrial appendage occlusion is associated with an increased occurrence of heart failure.
- Key predictors for developing HF post-LAAO include prior HF history, left ventricular mass index, E/e' ratio, and abnormal left atrial strain.
- These identified parameters should be evaluated prior to performing LAAO.
Background:
Left atrial appendage occlusion (LAAO) plays an important role in preventing stroke in patients with atrial fibrillation. However, LAAO may interact unfavorably with left atrial (LA) compliance and reservoir function and thus increase the risk of heart failure (HF). The purpose of this study was to identify predictors of subsequent HF after successful LAAO.
Methods And Results:
A total of 98 patients (mean age 70±9 years, 68% male) who had undergone LAAO were included. The primary endpoint was unexpected HF admission after LAAO. During a mean period of 36±26 months, 16 of the 98 patients (16%) experienced hospital HF admission. In multivariate analysis, higher E/e' (hazard ratio [HR] 1.11, 95% confidence interval [CI] 1.02-1.20, P=0.014), higher left ventricular mass index (HR 1.02, 95% CI 1.00-1.03, P=0.023), history of HF (HR 4.78, 95% CI 1.55-14.7, P=0.006), and lower LA strain (HR 0.80, 95% CI 0.70-0.93, P=0.003) were independently associated with hospital HF admission. Patients with LAAO had a significantly higher incidence of subsequent HF than the control group after propensity score matching (P=0.046).
Conclusions:
LAAO increases the occurrence of HF, and it is not uncommon after successful LAAO. A previous history of HF, left ventricular mass index, E/e', and abnormal LA strain are independently associated with the development of HF. These parameters should be considered before attempting LAAO.
Related Concept Videos
01:29Heart Failure II: Pathophysiology
01:22Heart Failure VI: Adjunct Therapies
01:17Pathophysiology of Heart Failure
01:27Heart Failure I: Introduction
01:29Cardiomyopathy III: Hypertrophic Cardiomyopathy
01:29Cardiomyopathy V: Interprofessional Care