A Current Perspective on Left Atrial Appendage Closure Device Infections: A Systematic Review

Area of Science:

• Cardiology
• Infectious Diseases
• Medical Device Technology

Background:

• Left atrial appendage (LAA) closure is a standard treatment for atrial fibrillation (AF) patients at high risk of thromboembolism.
• LAA occlusion device infection is a rare but serious complication with limited data on management and outcomes.

Purpose of the Study:

• To summarize the existing literature on LAA occlusion device infections.
• To highlight knowledge gaps in the diagnosis, management, and outcomes of these infections.

Main Methods:

• A comprehensive literature search was conducted across major biomedical databases (PubMed/MEDLINE, EMBASE, Web of Science, CINAHL, Cochrane Central).
• Included case reports with data on diagnosis, treatment, and outcomes of LAA occlusion device infections.

Main Results:

• Analyzed 12 case reports involving 12 patients (mean age 73.6 years, 50% male).
• Watchman device was most common; median time to infection was 6.6 months. Staphylococcus aureus was the most frequent pathogen.
• Device removal occurred in 7 cases; mortality was 25% (3/12), all during hospitalization.

Conclusions:

• LAA closure device infections are rare but associated with high complication and mortality rates.
• Device removal is recommended in appropriate cases; antibiotic therapy alone is suitable for selected patients.
• Further research is needed to establish clear diagnostic and treatment strategies based on pathogens and patient status.