Change in hospitalization rates following transcatheter left atrial appendage occlusion

Area of Science:

• Cardiology
• Interventional Cardiology
• Public Health

Background:

• Left atrial appendage occlusion (LAAO) is recommended for non-valvular atrial fibrillation (AF) patients with contraindications or intolerance to oral anticoagulants (OAC).
• The impact of LAAO on hospitalization rates remains under-described.
• Understanding hospitalization trends post-LAAO is crucial for patient management and healthcare resource allocation.

Purpose of the Study:

• To evaluate the incidence of all-cause, bleeding-related, and thrombosis-related hospitalizations before and after LAAO.
• To assess the effectiveness of LAAO in reducing hospital admissions in a real-world patient population.
• To provide evidence supporting the clinical utility of LAAO in specific AF patient groups.

Main Methods:

• Utilized the Nationwide Readmission Database (NRD) for patient data.
• Included patients aged 18+ diagnosed with AF who underwent transcatheter LAAO between February and November 2016-2018.
• Excluded patients who died during the procedure or had incomplete data on hospital stay or mortality.

Main Results:

• A total of 27,633 patients were analyzed (median age 77, 41% female).
• Post-LAAO, there was a 26% reduction in all-cause admissions (RR=0.74), a 49% reduction in bleeding-related admissions (RR=0.51), and a 71% reduction in thrombosis-related readmissions (RR=0.29).
• The proportion of patients with admissions decreased from 39.1% pre-LAAO to 26.0% post-LAAO.

Conclusions:

• Transcatheter LAAO is associated with a significant decrease in all-cause, bleeding-related, and thrombosis-related hospital admissions.
• These findings support the current clinical use of LAAO for AF patients with contraindications or high bleeding risk on OAC.
• LAAO demonstrates a favorable impact on reducing healthcare utilization in this patient cohort.