Key result
Left atrial appendage occlusion in patients with atrial fibrillation and chronic kidney disease was associated with a low incidence of stroke or transient ischemic attack (2.17%) and bleeding (4.53%) during follow-up.
Why the study?
To provide evidence on the clinical application of LAAO in AF patients with CKD, who frequently experience AF.
Does left atrial appendage occlusion safely prevent stroke and minimize bleeding in atrial fibrillation patients with chronic kidney disease?
Meta-Analysis (n=905)
Does left atrial appendage occlusion safely prevent stroke and minimize bleeding in atrial fibrillation patients with chronic kidney disease?
Left atrial appendage occlusion is a safe and effective alternative for stroke prevention in atrial fibrillation patients with chronic kidney disease, demonstrating low rates of perioperative complications and follow-up stroke/TIA and bleeding events.
Supports LAAO consideration for stroke prevention in AF with CKD; extends safety data to this high-risk population.
Atrial fibrillation (AF) is the most common arrhythmia among the elderly, and more frequently occur in those with chronic kidney disease (CKD). Left atrial appendage occlusion (LAAO) is used as a mechanical alternative approach for prevention of AF-related thromboembolisms. This meta-analysis was conducted to provide suggestions for the clinical application of LAAO in AF patients with CKD. The incidence of perioperative adverse events and other clinical effects after operation was by a single rate meta-analysis. Results showed that incidence of adverse events in the perioperative period after LAAO was generally low, with only pericardial effusion / tamponade (1.90%) and mortality rate (1.10%). During the follow-up period, the incidence of stroke/transient ischemic attack (TIA) and bleeding were 2.17% and 4.53%, respectively. A low incidence rate of adverse events was found in the perioperative period following LAAO. These results indicate that LAAO more effectively prevents the occurrence of stroke/TIA and minimizes bleeding events than oral anticoagulants.
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Zhang et al. (2020) conducted a meta-analysis in Atrial fibrillation with chronic kidney disease (n=905). Left atrial appendage occlusion (LAAO) vs. None (single-arm meta-analysis) was evaluated on Incidence of stroke/transient ischemic attack (TIA) during follow-up (OR 0.03, 95% CI 0.02-0.05). Left atrial appendage occlusion in patients with atrial fibrillation and chronic kidney disease was associated with a low incidence of stroke or transient ischemic attack (2.17%) and bleeding (4.53%) during follow-up.
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