Left Atrial Appendage Closure in Atrial Fibrillation Patients with Cancer

David Zweiker ^1,2, Jutta Bergler-Klein ³, Lukas Fiedler ⁴

¹Division of Cardiology, Medical University of Graz, 8036 Graz, Austria.
²Third Department for Cardiology and Intensive Care, Clinic Ottakring, 1160 Vienna, Austria.
³Department of Cardiology, University Clinic of Internal Medicine II, Medical University of Vienna, 1090 Vienna, Austria.
⁴Department of Internal Medicine, Cardiology and Nephrology, Hospital Wiener Neustadt, 2700 Wiener Neustadt, Austria.
⁵Department of Cardiology, Clinic Floridsdorf, 1210 Vienna, Austria.
⁶Department of Internal Medicine II, Klinikum Wels-Grieskirchen, 4600 Wels, Austria.
⁷Department of Internal Medicine III, University Hospital St. Pölten, 3100 St. Pölten, Austria.
⁸Department of Cardiology, Kepler University Hospital, 4020 Linz, Austria.
⁹Department of Internal Medicine III, Medical University of Innsbruck, 6020 Innsbruck, Austria.
¹⁰Department of Internal Medicine II, Elisabethinen Hospital, 4020 Linz, Austria.
¹¹Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, 6229 Maastricht, The Netherlands.

⁰Division of Cardiology, Medical University of Graz, 8036 Graz, Austria.

Journal of Clinical Medicine +

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November 9, 2024

View abstract on PubMed

Summary

Left atrial appendage closure (LAAC) is a safe and effective treatment for patients with cancer, showing similar outcomes to those without cancer. This study confirms LAAC

Area Of Science

Cardiology
Interventional Cardiology
Oncology

Background

Limited data exist on left atrial appendage closure (LAAC) in cancer patients.
This study addresses the safety and efficacy of LAAC in this population.

Purpose Of The Study

To compare outcomes of LAAC in patients with and without a history of cancer.
To assess the relationship between baseline characteristics and outcomes in these groups.

Main Methods

Sub-analysis of the prospective Austrian LAAC Registry.
Included 486 consecutive patients, with 57 having a history of cancer.
Used inverse probability weighting to adjust for baseline characteristic differences.

Main Results

Cancer patients were older, with higher rates of anemia and GI bleeding.
No significant differences in major procedural complications (5.3% vs. 7.0%).
Similar 5-year survival (80.7% vs. 84.8%) and 1-year survival (96.1% vs. 94.0%) between groups.

Conclusions

LAAC is an accepted treatment option for cancer patients in clinical practice.
Short-term and long-term outcomes of LAAC are comparable in cancer and non-cancer patients.
This supports the use of LAAC in selected cancer patients.

Keywords:

anticoagulation atrial fibrillation cancer cardio-oncology complications left atrial appendage closure malignancy