What is the clinical evidence from this study?

Study design: Observational. Population: Atrial fibrillation and previous intracranial hemorrhage (n=20). Intervention: Percutaneous left atrial appendage occlusion (LAAO). Primary outcome: Major complications (periprocedural stroke, death, pericardial effusion, device embolism) and ischemic or hemorrhagic stroke.

December 7, 2013NeurologyOpen Access

Left atrial appendage occlusion in atrial fibrillation after intracranial hemorrhage

View Full Paper

Ask AI

Bookmark

Key result

Percutaneous left atrial appendage occlusion in patients with atrial fibrillation and previous intracranial hemorrhage resulted in no procedure-related complications or strokes over 13.6 months.

Why the study?

Is percutaneous LAAO safe and feasible in patients with atrial fibrillation and previous intracranial hemorrhage?

Key Points

To evaluate the safety and feasibility of percutaneous left atrial appendage occlusion in patients with atrial fibrillation and a prior history of intracranial hemorrhage.
Conducted an explorative, prospective, single-center observational study of percutaneous left atrial appendage occlusion using the Amplatzer Cardiac Plug device in N=20 patients with atrial fibrillation and prior intracranial hemorrhage.
Calculated baseline thromboembolic and bleeding risks using CHA2DS2-VASc and HAS-BLED scores, monitoring clinical outcomes and predefined major complications at 1, 6, 12, and 24 months post-procedure.
Zero procedure-related major complications occurred, while minor postprocedural complications occurred in 4/20 patients (2 inguinal hematomas, 1 self-limiting asystole, and 1 device thrombus).
No ischemic or hemorrhagic strokes occurred during a mean follow-up of 13.6 ± 8.2 months, despite high baseline annual stroke risk (mean CHA2DS2-VASc 4.5 ± 1.4; 4.0%-6.7%) and bleeding risk (mean HAS-BLED 4.7 ± 1.0; 8.7%-12.5%).

Study Design

Type

Observational (n=20)

Multicenter

Structured PICO

Is percutaneous LAAO safe and feasible in patients with atrial fibrillation and previous intracranial hemorrhage?

Population

20 patients with atrial fibrillation and previous intracranial hemorrhage followed for a mean of 13.6 months.

Exposure

Percutaneous left atrial appendage occlusion (LAAO) using the Amplatzer Cardiac Plug device.

Outcome

Safety and feasibility (major complications predefined as periprocedural stroke, death, pericardial effusion, and device embolism).safety

Percutaneous LAAO appears safe and feasible for stroke prevention in high-risk patients with atrial fibrillation and a history of intracranial hemorrhage.

Limitations

Small sample size and lack of a control group; a larger, controlled trial is needed to assess efficacy and safety.
Small sample size
Lack of control group

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

Supports LAAO feasibility in high-risk AF with prior ICH; leaves open need for randomized trials before practice change.

Cite This Study

Horstmann et al. (2013) conducted an observational in Atrial fibrillation and previous intracranial hemorrhage (n=20). Percutaneous left atrial appendage occlusion (LAAO) was evaluated on Major complications (periprocedural stroke, death, pericardial effusion, device embolism) and ischemic or hemorrhagic stroke. Percutaneous left atrial appendage occlusion in patients with atrial fibrillation and previous intracranial hemorrhage resulted in no procedure-related complications or strokes over 13.6 months.

synapsesocial.com/papers/6a773347df493903fd1ebdae https://doi.org/10.1212/wnl.0000000000000022

Topics

Left atrial appendage closure Atrial fibrillation Persistent AF management Anticoagulation in AF AF ablation outcomes

View Full Paper

Ask AI

Bookmark

Left atrial appendage occlusion in atrial fibrillation after intracranial hemorrhage

Key Points

Study Design

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Topics

Left atrial appendage occlusion in atrial fibrillation after intracranial hemorrhage

Key Points

Study Design

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider