Left Atrial Appendage Closure Outcomes in Patients With Cancer at a Single Tertiary Center.

Area of Science:

• Cardiology
• Oncology
• Interventional Cardiology

Background:

• Atrial fibrillation is common in cancer patients, who face high risks of bleeding and thromboembolism, complicating anticoagulation.
• Left atrial appendage closure (LAAC) offers an alternative for patients with atrial fibrillation and high bleeding risk, but data in cancer patients are limited.

Purpose of the Study:

• To compare the long-term safety and efficacy of percutaneous left atrial appendage closure (LAAC) using the WATCHMAN device in patients with and without cancer.

Main Methods:

• A prospective, single-center study included 389 patients undergoing WATCHMAN LAAC over 5 years.
• Outcomes (mortality, stroke, major bleeding) were evaluated in 57 cancer patients and 332 non-cancer patients.
• Median follow-up was 354 days.

Main Results:

• No significant differences were observed in 3-year mortality (HR 1.3), major bleeding (HR 1.2), or stroke (HR 0.64) between groups.
• The composite outcome of postprocedural mortality, stroke, and major bleeding also showed no difference (HR 1.25).
• Baseline characteristics were similar between the cancer and non-cancer groups.

Conclusions:

• Percutaneous LAAC with the WATCHMAN device appears safe in patients with cancer.
• Long-term risks for mortality, stroke, and bleeding are comparable between cancer patients and those without cancer undergoing LAAC.