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Updated: Oct 3, 2025
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Left Atrial Appendage Occlusion in Nonagenarians
Pedro Luis Cepas-Guillén, Boris Schmidt, Sergio Berti
1Hospital Clinic; C/Villarroel, 170, Cardiology Department; 08036 Barcelona, Spain. freixa@clinic.cat.
Insights
Percutaneous left atrial appendage occlusion (LAAO) shows promising safety and efficacy in nonagenarians. This study found successful implantation and no strokes or TIAs during 2-year follow-up for this elderly group.
Area of Science:
- Cardiology
- Geriatric Medicine
- Interventional Cardiology
Background:
- Nonagenarians represent a rapidly expanding, high-risk demographic.
- Limited data exists on percutaneous left atrial appendage occlusion (LAAO) outcomes in this population.
- Atrial fibrillation management in the very elderly presents unique challenges.
Purpose of the Study:
- To evaluate the safety and efficacy of LAAO in nonagenarian patients.
- To analyze procedural success and long-term clinical outcomes.
- To contribute data on LAAO for the oldest segment of the atrial fibrillation population.
Main Methods:
- Analysis of data from the prospective global Amplatzer Amulet observational study.
- Inclusion of 9 nonagenarian patients undergoing LAAO.
- 2-year follow-up for procedural adverse events and clinical outcomes.
Main Results:
- Successful Amulet device implantation in all nonagenarian patients.
- One major procedural adverse event: a pseudoaneurysm.
- Absence of ischemic strokes or transient ischemic attacks during the 2-year follow-up period.
Conclusions:
- LAAO appears to be a safe and effective option for stroke risk reduction in nonagenarians with atrial fibrillation.
- Favorable outcomes observed in this small cohort warrant further investigation.
- This study supports considering LAAO for very elderly patients at high risk for stroke.
Background:
Nonagenarians constitute a fast-growing and high-risk segment of the population, with scarce data on specific outcomes for percutaneous left atrial appendage occlusion (LAAO). The aim of the present paper was to assess the outcomes of nonagenarian patients undergoing LAAO from the prospective global Amplatzer Amulet observational study. Overall, 1088 subjects were prospectively included in the study. Among them, 9 (1%) were nonagenarians. Amulet device implant success was achieved in all patients and the only major procedural adverse event was a pseudoaneurysm. During the 2-year follow-up after LAAO, no ischemic strokes or transient ischemic attacks were reported. Further studies will be necessary to confirm the favorable LAAO outcomes in this growing segment of the atrial fibrillation population.
