What does this research mean for the field?

Patients with atrial fibrillation and rheumatic heart disease have higher bleeding rates after left atrial appendage occlusion, but similar stroke/TIA rates compared to those without these conditions. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

January 25, 2026

Outcomes of Left Atrial Appendage Occlusion in Patients With Hypertrophic Cardiomyopathy, Rheumatic Heart Disease, and Cardiac Amyloidosis.

Key Result

Patients with atrial fibrillation and rheumatic heart disease had higher bleeding rates after LAAO, but similar stroke/TIA rates compared to those without these conditions.

Key Points

The study aims to investigate the outcomes of left atrial appendage occlusion in patients with various heart diseases.
Compared bleeding rates post-LAAO in patients with AF and specific heart conditions.
Analyzed outcomes in cohorts of patients with hypertrophic cardiomyopathy, rheumatic heart disease, and cardiac amyloidosis.
Examined stroke and TIA rates among these groups.
Patients with AF and rheumatic heart disease or cardiac amyloidosis had higher bleeding rates post-LAAO.
No differences in outcomes were observed between AF patients with and without hypertrophic cardiomyopathy.
Findings in HCM and cardiac amyloidosis groups are primarily hypothesis generating due to small sample sizes.

Structured PICO

Does left atrial appendage occlusion (LAAO) have different bleeding and stroke/TIA outcomes in AF patients with HCM, RHD, or CA compared to those without these conditions?

Population

Patients with atrial fibrillation (AF) and either hypertrophic cardiomyopathy (HCM), rheumatic heart disease (RHD), or cardiac amyloidosis (CA).

Intervention

Left atrial appendage occlusion (LAAO)

Comparator

Patients with AF undergoing LAAO without HCM, RHD, or CA

Outcome

Bleeding rates and stroke/TIA rateshard clinical

LAAO in AF patients with RHD or CA is associated with higher bleeding risk compared to those without these conditions, though stroke/TIA rates remain similar in the RHD cohort.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Patients with AF and either RHD or CA experienced higher bleeding rates following LAAO compared with those without these conditions, despite similar stroke/TIA rates in AF + RHD, suggesting a higher inherent bleeding risk and possibly further supporting a role of LAAO. Importantly, there was no difference in outcomes between patients with AF and HCM vs those without. Because of the small sample size, the results in HCM and CA cohorts are mainly hypothesis generating.

Bookmark