Arrhythmias & electrophysiology
Clinical outcomes of patients referred for left atrial appendage exclusion who did and did not undergo the procedure
Authors' conclusion
After a comprehensive evaluation in a multidisciplinary clinic, ∼50% of the patients referred for LAAE did not proceed with LAAE and resumed anticoagulation.
Study context
- Population
- Patients with AF referred to a multidisciplinary left atrial appendage exclusion (LAAE) clinic, University of Michigan, 2016–2022
- Participants
- 301 consecutive patients
- Exposure
- LAAE vs no LAAE in patients referred to a multidisciplinary LAAE clinic
- LAAEn = 168
- no-LAAEn = 133reference
- Outcome
- Management strategies and long-term clinical outcomes (death, thromboembolic events, bleeding complications)
- Follow-up
- Median 2.2 years (IQR 1.2-4.0 years)
Methodological detailsprospectively acquired data, single-centre, consecutive patients, CHA2DS2-VASc (4.7 ± 1.5 vs 4.1 ± 1.6; P = .002) and HAS-BLED (3.4 ± 1.0 vs 2.8 ± 1.1; P < .001) higher in LAAE
- Prospectively acquired data
- Single-centre
- Consecutive patients
- CHA2DS2-VASc (4.7 ± 1.5 vs 4.1 ± 1.6; P = .002) and HAS-BLED (3.4 ± 1.0 vs 2.8 ± 1.1; P < .001) higher in LAAE
Main finding
As reported in the abstract
Long-term clinical outcomes · median 2.2 years
| Group | Deaths | Thromboembolic events | Bleeding complications |
|---|---|---|---|
| LAAE | 39 (23%) | 13 (8%) | 24 (14%) |
| no-LAAE | 29 (22%) | 5 (4%) | 23 (17%) |
Deaths
LAAE39 (23%)
no-LAAE29 (22%)
Thromboembolic events
LAAE13 (8%)
no-LAAE5 (4%)
Bleeding complications
LAAE24 (14%)
no-LAAE23 (17%)
Observational data: associations, not effects.
Further findings
| Outcome | no-LAAE | P value |
|---|---|---|
| Anticoagulant therapy discontinuedWatchman vs no-LAAE | 61% | P < 0.001 |
- Anticoagulant therapy discontinued: Watchman 94%
- Anticoagulant therapy discontinued: 137 of 146 vs 61 of 133
Safety
Bleeding complications · median 2.2 years
Original publication
Clinical outcomes of patients referred for left atrial appendage exclusion who did and did not undergo the procedure. Heart Rhythm. Published 23 February 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →