Key result
LARIAT LAAC linked to ~81% lower thromboembolism risk in AF patients.
Why the study?
LAAC with the LARIAT device offers an alternative to OAC in AF, but long-term clinical outcome data were needed.
Does left atrial appendage closure with the LARIAT device prevent thromboembolic events and bleeding in patients with atrial fibrillation?
Cohort (n=139)
No
Does left atrial appendage closure with the LARIAT device prevent thromboembolic events and bleeding in patients with atrial fibrillation?
Effect estimate: 81% risk reduction
Left atrial appendage closure with the LARIAT device is associated with low rates of thromboembolism and severe bleeding over long-term follow-up in patients with atrial fibrillation.
May support LARIAT evaluation in anticoagulation-intolerant AF; leaves open randomized confirmation of net benefit.
INTRODUCTION: Left atrial appendage closure (LAAC) with LARIAT offers an alternative to oral anticoagulation (OAC) for patients with atrial fibrillation. The aim of this study was to present long-term clinical outcomes of LAAC in these patients (AF). MATERIAL AND METHODS: A prospective, single-center study was performed in 139 patients undergoing LAAC with Lariat. Thromboembolic events, severe bleeding and mortality rate were recorded. The reduction in risk of thromboembolism and bleeding after LAAC was calculated. RESULTS: The mean CHADS2-score was 1.8 ± 1.0, mean CHA2DS2-VASc score was 2.9 ± 1.6 and HAS-BLED score was 3.1 ± 1.1. After 428.4 patient-years of follow-up (mean 4.2±1.0 years), the thromboembolism rate was 0.6% with a calculated thromboembolism risk reduction of 81%. The severe bleeding rate was 0.8%; calculated bleeding risk reduction was 78%. The overall mortality rate was 1.6%. CONCLUSIONS: Long-term outcomes show that LAAC with Lariat is a safe and effective treatment for stroke prevention and bleeding risk reduction in AF patients with a high level of underlying risk.
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Litwinowicz et al. (2018) conducted a cohort in Atrial fibrillation (n=139). Left atrial appendage closure with LARIAT was evaluated on Thromboembolic events (81% risk reduction). Left atrial appendage closure with the LARIAT device in atrial fibrillation patients resulted in a thromboembolism rate of 0.6% and an 81% calculated risk reduction over a mean 4.2 years.
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