Key result
Left atrial appendage closure was successfully performed in all 36 patients with hypertrophic cardiomyopathy and atrial fibrillation, resulting in no thromboembolic events or deaths over a mean follow-up of 28.4 months.
Why the study?
The efficacy of left atrial appendage closure for primary and secondary stroke prevention in patients with hypertrophic cardiomyopathy and atrial fibrillation was not established.
Does left atrial appendage closure (LAAC) prevent stroke and allow freedom from anticoagulation in patients with hypertrophic cardiomyopathy and atrial fibrillation?
Observational (n=36)
No
Does left atrial appendage closure (LAAC) prevent stroke and allow freedom from anticoagulation in patients with hypertrophic cardiomyopathy and atrial fibrillation?
Left atrial appendage closure appears to be a safe and feasible alternative for stroke prevention in selected patients with hypertrophic cardiomyopathy and atrial fibrillation, allowing for the discontinuation of anticoagulation.
Background: The aim of this study was to investigate the efficacy of left atrial appendage closure (LAAC) for primary and secondary stroke prevention in patients with hypertrophic cardiomyopathy (HCM) and atrial fibrillation (AF). Methods: This pilot study enrolled 36 patients with HCM and AF who underwent LAAC between April 2017 and December 2019, of whom 22 were for primary stroke prevention and 14 were for secondary prevention. Results: The patients enrolled in this study had non-obstructive (86.1%) or mild obstructive (13.9%) HCM. Patients in the Secondary Prevention Group had higher CHA2DS2-VASc scores (5.1 ± 1.4 vs. 2.6 ± 1.6, P < 0.001) and higher HAS-BLED scores (2.8 ± 1.0 vs. 1.5 ± 0.9, P < 0.001) compared with those in the Primary Prevention Group. Successful closure with satisfactory seals (residual leak ≤ 5 mm) was achieved in all patients, with complete occlusion in 86.4% of the Primary Prevention Group and 92.9% of the Secondary Prevention Group. Procedural-related complications included one pericardial effusion and one groin hematoma. One device-related thrombus was identified in the Secondary Prevention Group and resolved after anticoagulation. During a mean follow-up time of 28.4 months, one bleeding event was recorded. There were no thromboembolic events or deaths in either group, with 97.2% of the patients achieving freedom from anticoagulation therapy. Conclusions: Initial results suggest that LAAC can be a safe and feasible alternative for primary and secondary stroke prevention in selected patients with HCM and AF. Further studies with larger samples are required.
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Mo et al. (2021) conducted an observational in Hypertrophic cardiomyopathy and atrial fibrillation (n=36). Left atrial appendage closure (LAAC) was evaluated on Thromboembolic events and mortality. Left atrial appendage closure was successfully performed in all 36 patients with hypertrophic cardiomyopathy and atrial fibrillation, resulting in no thromboembolic events or deaths over a mean follow-up of 28.4 months.
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