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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Outcomes of Left Atrial Appendage Occlusion in Patients With Cardiac Amyloidosis

Sonia Kshatri1, David Lewandowski2, Jake Luo3

  • 1Department of Internal Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.

Structural Heart : the Journal of the Heart Team
|February 24, 2026
PubMed

Insights

Patients with cardiac amyloidosis and atrial fibrillation undergoing left atrial appendage occlusion have similar outcomes to those without the condition. However, a deeper analysis revealed potentially worse results in cardiac amyloidosis patients.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Cardiovascular Medicine

Background:

  • Patients with cardiac amyloidosis (CA) and atrial fibrillation face high risks of thromboembolic and bleeding events.
  • Left atrial appendage occlusion (LAAAO) is a potential treatment, but data in CA patients is limited.

Purpose of the Study:

  • To evaluate the safety and efficacy of LAAAO in patients with CA and atrial fibrillation.
  • To compare outcomes between CA patients and non-CA patients undergoing LAAAO.

Main Methods:

  • Retrospective analysis of patients undergoing LAAAO.
  • Comparison of a composite primary outcome (death, stroke, transient ischemic attack, thromboembolic events) between CA and non-CA groups.
  • Propensity score-matched analysis to adjust for baseline differences.

Main Results:

  • No significant difference in the overall composite primary outcome between CA and non-CA patients.
  • CA patients with intermediate to high CHA 2 DS 2 -VASc scores had outcomes similar to comparable non-CA patients.
  • Propensity-matched analysis indicated significantly worse outcomes in patients with CA.

Conclusions:

  • LAAAO may be a viable option for CA patients with atrial fibrillation, showing comparable outcomes to non-CA patients in initial analysis.
  • Further investigation and careful patient selection are warranted, as propensity-matched analysis suggests potential increased risks in CA patients.

Keywords:
Atrial fibrillationLeft atrial appendage occlusionStroke

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