Percutaneous left atrial appendage occlusion in a real-world cohort was associated with low long-term rates of stroke (2.8%) and bleeding (10%), but high all-cause mortality (29%).
Cohort (n=549)
Yes
Real-world data from Ontario demonstrates that LAAO is associated with low long-term stroke and bleeding rates, though all-cause mortality in this high-risk population remains high at 29%.
Background Percutaneous left atrial appendage occlusion (LAAO) is an alternative for stroke prevention in patients with atrial fibrillation (AF) with contraindications to oral anticoagulation (OAC). Population level real-world data describing the use and outcomes of LAAO procedures are evolving with a paucity of longer-term follow-up data. We report on the patient characteristics, procedure complications, and longer-term clinical outcomes in all patients undergoing LAAO procedures in Ontario, Canada. Methods All patients undergoing LAAO procedure between April 1 st 2013 and March 31 st 2022 were identified. Linked administrative databases were utilized to determine patient clinical and procedural characteristics. Outcomes of interest included procedure complications at 7 and 30 days and longer-term rates of stroke, bleeding, all-cause re-hospitalization and mortality. Results 549 individuals were included in the study cohort. The average age was 75±8 years, with 66% male sex, a mean CHA 2 DS 2 VASc score of 4.4±1.6, and 68% were not receiving oral anticoagulation. Follow-up for 2.6±2.0 patient-years was available. Stroke occurred in 2.8% during the follow-up period (1.1/100 patient-years), bleeding in 10% (4.0/100 patient-years) and any hospital re-admission in 63% (43/100 patient-years). 29% of the cohort died during the follow-up period (11/100 patient-years) with 1.8% of the cohort dying during the procedural hospitalization. The mortality rate was unchanged during the study period (p for trend=0.72). Conclusions Long-term stroke and bleeding rates are low in patients undergoing LAAO in Ontario, Canada. All-cause mortality in this population is high and remained unchanged during the study period.
Singh et al. (Mon,) conducted a cohort in Atrial fibrillation with contraindications to oral anticoagulation (n=549). Percutaneous left atrial appendage occlusion (LAAO) was evaluated on Procedure complications at 7 and 30 days and longer-term rates of stroke, bleeding, all-cause re-hospitalization and mortality. Percutaneous left atrial appendage occlusion in a real-world cohort was associated with low long-term rates of stroke (2.8%) and bleeding (10%), but high all-cause mortality (29%).
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