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January 1, 2017Arquivos Brasileiros de CardiologiaOpen Access

Left atrial appendage closure in patients with non-valvular atrial fibrillation achieved a 97.8% procedural success rate and a 2.2% stroke rate over 128.6 patient-years of follow-up.

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Why the study?

Does percutaneous left atrial appendage closure prevent stroke and bleeding in patients with non-valvular atrial fibrillation and restrictions to oral anticoagulation?

Population

91 patients with non-valvular atrial fibrillation, high stroke risk and restrictions to oral anticoagulation…

Comparison

Percutaneous Left Atrial Appendage Closure using… vs Expected rates based on CHA2DS2VASc and HASBLED…

Design

Cohort

Follow-up

128.6 patient-years

Key result

Left atrial appendage closure in patients with non-valvular atrial fibrillation achieved a 97.8% procedural success rate and a 2.2% stroke rate over 128.6 patient-years of follow-up.

Authors

ÊGÊnio Eduardo GuériosFCFrancisco ChamiéMMMárcio José Montenegro

Discussion

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Overview

Supports LAA closure feasibility in anticoagulation-restricted NVAF; leaves open randomized confirmation of stroke prevention.

Study Design

Type

Observational (n=91)

Multicenter

Yes

Structured PICO

Does percutaneous left atrial appendage closure prevent stroke and bleeding in patients with non-valvular atrial fibrillation and restrictions to oral anticoagulation?

P
Population
91 patients with non-valvular atrial fibrillation (NVAF), high stroke risk (CHA2DS2VASc score = 4.5 ± 1.5) and restrictions to oral anticoagulation (HAS-BLED score = 3.6 ± 1.0) across 11 centers in Brazil.
I
Intervention
Percutaneous Left Atrial Appendage Closure (LAAC) using either the Amplatzer cardiac plug or the Watchman device.
C
Comparator
Expected rates based on CHA2DS2VASc and HASBLED scores (no active control group).
O
Outcome
Immediate procedural results (success, complications) and late outcomes (death, bleeding, stroke, device thrombus).hard clinical

In a real-world Brazilian registry, percutaneous left atrial appendage closure showed high procedural success and low rates of stroke and bleeding in NVAF patients with restrictions to oral anticoagulation.

Limitations

  • Beginning of the learning curve of most of the involved operators

Cite This Study

Guérios et al. (2017) conducted an observational in Non-valvular atrial fibrillation (NVAF) (n=91). Left atrial appendage closure (LAAC) using Amplatzer cardiac plug or Watchman device was evaluated on Procedural success rate. Left atrial appendage closure in patients with non-valvular atrial fibrillation achieved a 97.8% procedural success rate and a 2.2% stroke rate over 128.6 patient-years of follow-up.

synapsesocial.com/papers/6a125cc445487b7639a655fehttps://doi.org/10.5935/abc.20170150
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