Percutaneous Left Atrial Appendage Occlusion for Atrial Fibrillation in Cardiac Amyloidosis

Area of Science:

• Cardiology
• Cardiovascular Research
• Medical Devices

Background:

• Cardiac amyloidosis (CA) frequently co-occurs with atrial fibrillation (AF).
• Outcomes following left atrial appendage occlusion (LAAO) in AF patients with CA are not well-established.
• Understanding LAAO efficacy and safety in CA is crucial for patient management.

Purpose of the Study:

• To compare the outcomes of LAAO in patients with and without cardiac amyloidosis.
• To evaluate the safety and efficacy of LAAO in the specific population of AF patients with CA.
• To provide data for clinical decision-making regarding LAAO in CA patients.

Main Methods:

• Retrospective study using the TriNetX database.
• Inclusion of adult patients with atrial fibrillation undergoing LAAO.
• 1:1 propensity score matching to compare patients with and without cardiac amyloidosis.
• Kaplan-Meier analysis and Cox regression for outcome assessment.

Main Results:

• Study included 532 matched pairs of patients (with and without CA).
• Mortality and major adverse cardiovascular events were similar between the CA and non-CA groups.
• Major bleeding events were significantly higher in patients with cardiac amyloidosis (HR 1.90).

Conclusions:

• Left atrial appendage occlusion (LAAO) demonstrates comparable ischemic outcome benefits in patients with cardiac amyloidosis (CA) and atrial fibrillation (AF).
• A significantly increased risk of major bleeding is associated with LAAO in CA patients.
• These findings highlight the need for careful consideration of bleeding risk when performing LAAO in patients with CA.