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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Percutaneous left atrial appendage closure for stroke prevention in patients with chronic renal disease

Alexander Lind1, Obayda Azizy1, Julia Lortz1

  • 1Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany.

Archives of Medical Science : AMS
|April 10, 2023
PubMed

Insights

Left atrial appendage closure (LAAC) is a safe and effective stroke prevention method for patients with atrial fibrillation (AF) and chronic kidney disease (CKD). This procedure demonstrates feasibility and success even in patients with moderate to severe CKD.

Area of Science:

  • Cardiology
  • Nephrology

Background:

  • Atrial fibrillation (AF) is a common arrhythmia linked to increased stroke risk.
  • Chronic kidney disease (CKD) elevates stroke and mortality risk in AF patients.
  • Left atrial appendage closure (LAAC) is an alternative stroke prevention for AF patients with bleeding risks.

Purpose of the Study:

  • To assess the safety and feasibility of percutaneous LAAC in patients with CKD.
  • To evaluate outcomes of LAAC in AF patients stratified by CKD severity.

Main Methods:

  • An observational, single-center study included 97 AF patients undergoing LAAC.
  • Patients were categorized into mild (KDOQI I-II) and moderate-to-severe (KDOQI III-V) CKD groups.
  • Outcomes included procedural success, occlusion, stroke prevention, and bleeding complications.

Main Results:

  • Patients with moderate-to-severe CKD had higher thromboembolic and bleeding risk scores (CHA2DS2-VASc, HAS-BLED).
  • Procedural and occlusion success rates were similar between CKD groups (97.9% vs. 95.9%).
  • Effective stroke prevention and no bleeding complications were observed at 6-36 months follow-up in both groups.

Conclusions:

  • Percutaneous LAAC is a safe and feasible stroke prevention strategy for AF patients with CKD.
  • The procedure is effective regardless of CKD severity, offering a viable option for high-risk patients.
Abstract

Keywords:
bleedingchronic renal diseasecomplicationsleft atrial appendage closurestroke

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