Why the study?
In countries where anticoagulation is not recommended in hemodialysis patients, the feasibility of percutaneous LAAC in hemodialysis patients with NVAF and high risks of thromboembolic stroke and bleeding remains unknown.
Does percutaneous left atrial appendage closure have comparable safety and short-term feasibility in hemodialysis patients compared to non-hemodialysis patients with non-valvular atrial fibrillation and high bleeding risk?
Population
118 NVAF patients (25 hemodialysis and 93 non-hemodialysis)
Comparison
Hemodialysis vs non-hemodialysis patients undergoing LAAC with WATCHMAN
Design
Retrospective single-institute comparative study
Follow-up
45-day observational period
Key result
Percutaneous left atrial appendage closure demonstrated a 100% procedural success rate in hemodialysis patients, with no significant difference in major complications compared to non-hemodialysis patients at 45 days.
Authors
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May support LAAC feasibility in high-risk Japanese hemodialysis patients with NVAF; hypothesis-generating and leaves open need for prospective trials.
Cohort (n=118)
No
Does percutaneous left atrial appendage closure have comparable safety and short-term feasibility in hemodialysis patients compared to non-hemodialysis patients with non-valvular atrial fibrillation and high bleeding risk?
Absolute Event Rate: 100% vs 99%
p-value: p=0.60
Percutaneous left atrial appendage closure appears feasible and safe in the short term for hemodialysis patients with non-valvular atrial fibrillation and high bleeding risk.
Ueno et al. (2022) conducted a cohort in Non-valvular atrial fibrillation with high risk of bleeding (n=118). Hemodialysis (in patients undergoing left atrial appendage closure) vs. Non-hemodialysis was evaluated on Procedure success (p=0.60). Percutaneous left atrial appendage closure demonstrated a 100% procedural success rate in hemodialysis patients, with no significant difference in major complications compared to non-hemodialysis patients at 45 days.