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One-Year Clinical Outcomes and the Impact of Proce ...
Article: One-Year Clinical Outcomes and the Impact ...
Article: One-Year Clinical Outcomes and the Impact of Procedural Configurations in Left Atrial Appendage Occlusion Patients
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The study observed one-year clinical outcomes in patients undergoing left atrial appendage occlusion (LAAO) and assessed the influence of different procedural configurations and anticoagulation regimens. Conducted across 39 Chinese centers, the study included 3,096 patients with nonvalvular atrial fibrillation who were ineligible or unsuitable for long-term oral anticoagulation.<br /><br />Results at the one-year mark showed that 133 patients (4.51%) experienced a composite ischemic endpoint of death, stroke, and systemic embolism, while 71 patients (2.36%) experienced life-threatening, disabling, or major bleeding events. The study observed no significant difference in outcomes between varying anesthesia types or imaging guidance modalities (fluoroscopy vs echocardiography) on these events.<br /><br />The most common antithrombotic strategy post-LAAO was warfarin or direct oral anticoagulant therapy for 45 days, followed by single or dual antiplatelet therapy. Notably, LAAO combined with catheter ablation, practiced in 42% of cases, resulted in a significantly lower rate of ischemic events compared to LAAO alone (3.5% vs. 5.2%).<br /><br />Despite deviations from guideline-recommended antithrombotic strategies, the study found that using direct oral anticoagulants alone (without aspirin) for 45 days post-LAAO was associated with fewer bleeding events, suggesting a potential need to reconsider current guideline recommendations.<br /><br />In conclusion, the study indicated favorable one-year outcomes for LAAO in Chinese patients for both ischemic and bleeding events, while suggesting that combined procedural techniques like catheter ablation might reduce ischemic risks further. However, these findings prompt the need for further randomized trials for validation.
Keywords
left atrial appendage occlusion
LAAO
clinical outcomes
anticoagulation regimens
nonvalvular atrial fibrillation
ischemic events
bleeding events
catheter ablation
direct oral anticoagulants
Chinese study
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