Transcatheter Left Atrial Appendage Occlusion: A Multi-Center Real Life Experience

Ziad Arow, Tzipi Hornik-Lurie, Mustafa Gabarin, Alexander Omelchenko, Rami Barashi, Yoav Arnson, Abid Assali, David Pereg*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

(1) Background: left atrial appendage occlusion (LAAO) is considered an effective and relatively safe treatment for the prevention of thromboembolic events in patients with atrial fibrillation and a contra-indication for anticoagulation. We present a large multicenter real-world experience of transcatheter LAAO implementation in patients with atrial fibrillation who cannot be treated with chronic anti-coagulation; (2) Methods: included were atrial fibrillation patients who underwent transcatheter LAAO between 1 January 2016 and 30 June 2021. The study was conducted using the electronic health record database of Clalit Health Services (CHS). The primary outcomes included hemorrhagic and ischemic stroke following LAAO; (3) Results: included were 389 atrial fibrillation patients. During a median follow-up of 2.1 years, 13% patients had ischemic cerebrovascular accident (CVA), and 4.4% patients had hemorrhagic CVA. While the risk of ischemic stroke increased gradually over time, the risk of hemorrhagic CVA was highest during the first 3 months following the procedure. Moreover, previous ischemic stroke was the only significant predictor for both hemorrhagic and ischemic stroke following LAAO; (4) Conclusions: while the annual performance rate of transcatheter LAAO has increased significantly over the past years, post procedural long-term prognosis remains poor with a substantial risk of both thrombotic and bleeding events.

Original languageEnglish
Article number6944
JournalJournal of Clinical Medicine
Volume11
Issue number23
DOIs
StatePublished - Dec 2022

Keywords

  • anticoagulation
  • atrial fibrillation
  • hemorrhagic CVA
  • ischemic CVA
  • left atrial appendage occlusion

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