Endocardial and epicardial left atrial appendage closure techniques showed comparable annual rates of thromboembolic events (2.6% vs 0.5%) and stroke (0.87% vs 0%) in patients with atrial fibrillation.
Cohort (n=55)
Yes
Does endocardial left atrial appendage closure provide comparable stroke prevention to epicardial closure in patients with non-valvular atrial fibrillation?
Endocardial and epicardial left atrial appendage closure techniques demonstrate comparable midterm stroke prevention and safety profiles in patients with non-valvular atrial fibrillation.
Absolute Event Rate: 2.6% vs 0.5%
BACKGROUND: Left atrial appendage closure (LAAC) became an alternative method for stroke prevention in patients with non-valvular atrial fibrillation (AF) intolerant to long term oral anticoagulation therapy. This study aimed to compare endocardial (Amulet and LAmbere occluders) and epicardial (Lariat) LAAC techniques. METHODS: -VAS score-matched patients with AF who underwent LAAC in two centers. RESULTS: There were 55 matched cases with the mean CHA2DS2-VASs score 4.4 ± 1.22 (p = 1). Overall follow-up was 308.2 patient-years. The Endocardial group patients were older and more often females with congestive heart failure and peripheral vascular disease. The epicardial group more frequently had a stroke/transient ischemic attack history. There were no differences in hypertension, diabetes mellitus, and indications for procedure between both groups. The mean HAS-BLED score was significantly higher in the endocardial group than in the epicardial group (4.3 ± 0.9 vs. 3.7 ± 1.3, p = .011). There were no differences in annual rates of thromboembolic events (2.6% vs 0.5%) and annual stroke (0.87% vs. 0%) between the endocardial and epicardial groups. CONCLUSION: Endocardial and Epicardial LAAC techniques show comparable implantation outcomes and safety profile and stroke prevention in patients with AF. Future randomized studies are needed to corroborate these initial results and assess long term mortality.
Litwinowicz et al. (Wed,) conducted a cohort in Non-valvular atrial fibrillation (n=55). Endocardial LAAC (Amulet and LAmbere occluders) vs. Epicardial LAAC (Lariat) was evaluated on Annual rates of thromboembolic events. Endocardial and epicardial left atrial appendage closure techniques showed comparable annual rates of thromboembolic events (2.6% vs 0.5%) and stroke (0.87% vs 0%) in patients with atrial fibrillation.
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