Key result
Amplatzer Amulet LAAO can trigger severe orthostatic hypotension successfully managed with pharmacologic therapy.
Case Report (n=1)
Severe orthostatic hypotension is a rare but manageable complication of LAAO with the Amplatzer Amulet, potentially driven by atrial natriuretic peptide-mediated diuresis, and can be treated pharmacologically without device removal.
Severe orthostatic hypotension may complicate Amulet LAAO and warrant monitoring; leaves open its incidence and predictors.
Atrial fibrillation (AF) is a common cardiac arrhythmia with increasing prevalence.1,2 AF is associated with significant morbidity and is responsible for roughly a quarter of ischemic strokes.3-5 The primary origin of thromboemboli in AF patients is the left atrial appendage (LAA).1 Left atrial appendage occlusion (LAAO) has emerged as an effective and safe method for reducing risk of ischemic stroke and mortality in AF patients, which can be performed via endocardial occlusion or epicardial closure.
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Kopreski et al. (2026) conducted a case report in Atrial fibrillation (n=1). Left atrial appendage occlusion (Amplatzer Amulet) was evaluated. Left atrial appendage occlusion using the Amplatzer Amulet caused severe orthostatic hypotension with blood pressure as low as 63/43 mm Hg, which was successfully managed with pharmacologic therapy.
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