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Updated: Sep 23, 2026
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
Outcomes of patients with cardiac amyloidosis undergoing percutaneous left atrial appendage occlusion
Siddharth Agarwal1, Sukriti Banthiya2, Agam Bansal3
1Department of Medicine, University of Oklahoma Health Sciences Center, 800 Stanton L. Young Blvd, AAT 5400, Oklahoma City, OK, USA.
Insights
Patients with cardiac amyloidosis undergoing left atrial appendage occlusion (LAAO) have increased peri-procedural risks. However, outcomes like bleeding and stroke-related readmissions showed no significant differences compared to other patients.
Area of Science:
- Cardiology
- Medical Devices
- Clinical Outcomes
Background:
- Limited data exists on left atrial appendage occlusion (LAAO) safety and efficacy in cardiac amyloidosis patients.
- Cardiac amyloidosis is an understudied condition in the context of LAAO procedures.
Purpose of the Study:
- To evaluate the safety and efficacy of LAAO devices in patients with cardiac amyloidosis.
- To compare outcomes of LAAO in cardiac amyloidosis patients versus those without.
Main Methods:
- Analysis of the National Readmissions Database (NRD) from 2016-2019.
- Inclusion of patients aged 18+ with atrial fibrillation undergoing LAAO.
- Multivariable logistic regression to assess cardiac amyloidosis association with outcomes.
Main Results:
- A cohort of 54,900 LAAO procedures included 220 (0.4%) with cardiac amyloidosis.
- Cardiac amyloidosis patients had higher odds of peri-procedural major adverse events (aOR: 2.69) and neurological complications (aOR: 5.48).
- No significant differences were observed in other complications, mortality, resource utilization, or 30/90/180-day readmissions.
Conclusions:
- Cardiac amyloidosis patients undergoing LAAO face increased peri-procedural complication risks.
- No significant differences in bleeding or stroke-related readmissions were found.
- Findings suggest a need for further prospective validation.
Background:
There is limited data on the safety and efficacy of left atrial appendage occlusion (LAAO) devices in patients with cardiac amyloidosis. We examined the outcomes of patients with cardiac amyloidosis undergoing LAAO device implantation in a nationally representative cohort of patients.
Methods:
The National Readmissions Database (NRD) was analyzed from 2016 to 2019 to identify patients ≥ 18 years old with atrial fibrillation (AF) undergoing LAAO. Patients were divided into those with cardiac amyloidosis and those without cardiac amyloidosis. A multivariable logistic regression model was utilized to assess the independent association of cardiac amyloidosis with in-hospital, 30-day/90-day/180-day outcomes after adjusting for confounders.
Results:
Our cohort included 54,900 LAAO implantation procedures, of which 220 (0.4%) had cardiac amyloidosis. Patients with cardiac amyloidosis had a lower proportion of women and a lower prevalence of comorbidities including anemia, obesity, diabetes, and peripheral vascular disorders but a higher prevalence of stroke, as compared to those without cardiac amyloidosis. On multivariable analysis, cardiac amyloidosis was associated with significantly higher odds of peri-procedural major adverse events (adjusted odds ratio [aOR]: 2.69; 95% confidence interval [CI]: 1.41-5.14; p<0.01) and neurological complications (aOR: 5.48; 95% CI: 2.47-12.8; p<0.01). There was no difference in the odds of other peri-procedural complications, in-hospital mortality, hospital resource utilization, and 30/90/180-day all-cause/bleeding/stroke-related readmissions between both groups.
Conclusion:
Patients with cardiac amyloidosis undergoing LAAO device implantation have an increased risk of peri-procedural complications without any difference in bleeding/stroke-related readmissions. These hypothesis-generating findings need validation in future prospective studies.
