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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
28:13

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Published on: February 26, 2013

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Combined left atrial appendage occlusion and catheter ablation procedure for left atrial arrhythmias: A real-world,

Stefan Preisendörfer1, Muhammad T Ayub1, Aakash Sheth1

  • 1Heart & Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.

Journal of Cardiovascular Electrophysiology
|October 16, 2024
PubMed

Insights

Combined percutaneous left atrial appendage occlusion (LAAO) and catheter ablation (CA) demonstrate similar safety and efficacy compared to LAAO alone. This real-world study found comparable outcomes in major complications, thrombosis, and mortality between the two procedures.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Electrophysiology

Background:

  • Limited real-world data exists comparing combined left atrial appendage occlusion (LAAO) and catheter ablation (CA) with LAAO alone.
  • Assessing the safety and efficacy of combined procedures is crucial for optimizing patient care.

Purpose of the Study:

  • To compare the safety and efficacy of combined LAAO and CA versus LAAO alone in a large real-world patient cohort.
  • To evaluate in-hospital complications, device-related outcomes, and clinical events at 6-month follow-up.

Main Methods:

  • Retrospective analysis of patients undergoing combined LAAO and CA versus LAAO alone from a large US hospital system (8/2020-2/2024).
  • Propensity score matching (1:2 ratio) was used to control for baseline characteristics, including device type, CHA2DS2-VASc, and HAS-BLED scores.
  • Outcomes assessed included procedural success, in-hospital complications, peri-device leak, device thrombosis, all-cause mortality, thromboembolic events, and bleeding events.

Main Results:

  • Successful LAAO implantation rates were identical (95.8%) in both groups.
  • In-hospital major and minor complications were similar between combined and LAAO-alone groups.
  • At 45 days and 6 months, peri-device leak, device-related thrombosis, all-cause mortality, thromboembolic, and bleeding events were comparable between the groups.

Conclusions:

  • Combined LAAO and CA is a safe and effective strategy with comparable outcomes to LAAO alone.
  • The findings support the use of combined procedures when indicated, offering similar safety profiles.
  • Further prospective studies may further elucidate long-term benefits and specific patient selection criteria.
Abstract

Keywords:
atrial fibrillationcatheter ablationcombined procedureleft atrial appendage occlusionpulmonary vein isolation

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