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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Safety and Efficacy of Left Atrial Appendage Occlusion in Cardiac Amyloidosis: A Single-Center Retrospective Study
Ahmed N Mohamed1, Khodor Chabaklo1, Ashraf Alzahrani2
1Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio, USA.
Insights
Left atrial appendage closure (LAAC) is a safe and effective stroke prevention method for cardiac amyloidosis (CA) patients. This study shows high procedural success and low complication rates in CA patients undergoing LAAC.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiac Electrophysiology
Background:
- Cardiac amyloidosis (CA) increases stroke risk, especially with atrial fibrillation (AF).
- CA patients often have high bleeding risk, complicating oral anticoagulation (OAC).
- Limited data exist on LAAC safety and efficacy in CA patients.
Purpose of the Study:
- To assess procedural success, safety, and clinical outcomes of LAAC in CA patients.
- To evaluate LAAC as a stroke prevention strategy in this high-risk population.
Main Methods:
- Retrospective analysis of 21 CA patients undergoing LAAC (Jan 2014 - Dec 2024).
- Collected data on demographics, procedures, management, and outcomes.
- Primary endpoints: procedural success, thromboembolic and bleeding events.
Main Results:
- 95% procedural success with no major intra- or peri-procedural complications.
- Median 24-month follow-up showed no device thrombosis or major leaks; 14.3% had minor leaks.
- 9.5% experienced major bleeding (on OAC), and 9.5% had ischemic stroke/TIA.
Conclusions:
- LAAC is a feasible and safe stroke prevention strategy for CA patients.
- High procedural success and low complication rates observed.
- LAAC offers a viable alternative for stroke risk management in CA.
Objective:
To evaluate procedural success, safety, and clinical outcomes of left atrial appendage closure (LAAC) in patients with cardiac amyloidosis (CA).
Background:
CA is a progressive, infiltrative cardiomyopathy associated with an elevated risk of thromboembolic events, particularly in the setting of atrial fibrillation (AF). These patients are often elderly and at higher risk of bleeding. While LAAC offers an alternative to oral anticoagulation (OAC) for stroke prevention in high-bleeding-risk AF patients, data on its safety and efficacy in CA remain limited.
Methods:
We retrospectively analyzed 21 patients with confirmed CA who underwent LAAC between January 2014 and December 2024. Data on demographics, procedural details, post-procedural management, and outcomes were collected. The primary endpoints were procedural success and incidence of post-procedure thromboembolic and bleeding events.
Results:
Most patients had wild-type transthyretin amyloidosis (90.5%) and persistent AF (71.4%). Procedural success was achieved in 95% of patients, with no intra- or peri-procedural complications. Over a median follow-up of 24 months, there were no cases of device-related thrombosis or major peri-device leaks. Three patients (14.3%) experienced minor peri-device leak. Two patients (9.5%) had major bleeding, which occurred while on post-procedural OAC. Two patients (9.5%) experienced ischemic stroke or TIA, and both patients were given DOAC as a result (Central illustration).
Conclusion:
LAAC appears to be a safe and feasible stroke prevention strategy for patients with CA, achieving high procedural success with low complication rates.
