Key result
Direct current cardioversion at the time of left atrial appendage occlusion achieved a 75% success rate without increasing postprocedural adverse events compared to LAAO alone (2.5% vs 5.0%, P=1.00).
Why the study?
The feasibility and safety of performing direct current cardioversion at the time of LAAO to restore sinus rhythm and relieve symptoms in AF patients had not been established.
Does direct current cardioversion at the time of left atrial appendage occlusion safely restore sinus rhythm in patients with atrial fibrillation?
Cohort (n=80)
No
Does direct current cardioversion at the time of left atrial appendage occlusion safely restore sinus rhythm in patients with atrial fibrillation?
Direct current cardioversion performed concurrently with left atrial appendage occlusion is feasible and safe, effectively restoring sinus rhythm without increasing periprocedural adverse events.
Background With an increasing number of patients undergoing left atrial appendage occlusion (LAAO), more attention is being paid to relieving clinical symptoms and improving the quality of life of these patients. For patients with atrial fibrillation (AF), direct current cardioversion (DCCV) is an alternate, nonpharmacological choice to restore sinus rhythm and relieve clinical symptoms. Objectives The purpose of this study was to assess the feasibility and safety of the DCCV at the time of LAAO for patients with AF. Methods Forty patients were enrolled in the DCCV group undergoing the DCCV at the time of LAAO. The control group undergoing LAAO alone was formed by 1:1 matching. Results In the DCCV group, cardioversion was immediately successful in 30 (75%) patients, of which 12 (40%) had AF recurrence at the three-month follow-up. The failed-DCCV group was older (73.70 ± 4.74 vs. 62.20 ± 9.01 years old, P = 0.000), had a faster postcardioversion heart rate (88.80 ± 16.58 vs. 70.97 ± 14.73 times, P = 0.03), and had a higher mean HAS-BLED score (4.00 vs. 3.00, P = 0.01) than the successful-DCCV group. No patients experienced periprocedural pericardial effusion, occluder displacement, device embolism, or >5 mm peridevice leakage. One patient experienced a transient ischemic attack (TIA) in the DCCV group during the follow-up. Conclusions The DCCV at the time of LAAO is feasible and safe for AF patients with contraindications for catheter ablation or AF recurrence after previous catheter ablation to restore the sinus rhythm and relieve clinical symptoms. The DCCV at the time of LAAO is more likely to succeed for younger patients and patients with lower HAS-BLED scores.
No takes yet. Share an insight, caveat, or question.
Meng et al. (2023) conducted a cohort in Atrial fibrillation (n=80). Direct current cardioversion (DCCV) at the time of LAAO vs. LAAO alone was evaluated on Postprocedural adverse events (p=1.00). Direct current cardioversion at the time of left atrial appendage occlusion achieved a 75% success rate without increasing postprocedural adverse events compared to LAAO alone (2.5% vs 5.0%, P=1.00).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: