Arrhythmias & electrophysiologyCohort study
Concomitant vs sequential atrial fibrillation ablation and left atrial appendage occlusion
- retrospective analysis
- Inverse probability weighted logistic regression
Authors' conclusion
Concomitant ablation and LAAO demonstrated comparable in-hospital stroke and pericardial effusion risks, but lower observed risks of bleeding and vascular complications compared to the cumulative risk across sequential procedures, supporting a single-session approach when clinically appropriate.
Study context
- Population
- Medicare fee-for-service beneficiaries with index left atrial appendage occlusion (LAAO) (January 1, 2017-June 30, 2024)
- Participants
- 182,582 LAAO recipients
- Exposure
- concomitant catheter ablation plus LAAO with the cumulative patient-level risk across sequential procedures
Main finding
As reported in the abstract
Procedure utilization · study period
underwent ablation during the study period
20.9%
within ± 6 months
7.7%
concomitantly
1.5%
Observational data: associations, not effects.
Further findings
In-hospital stroke and pericardial effusion
- did not differ after adjustment
Patient characteristics
- Concomitant and sequential patients were clinically similar; LAAO-only patients were older and had more comorbidities
Safety
| Outcome | aOR (95% CI) | P value | |
|---|---|---|---|
| Major bleeding · in-hospital · approximately 50% lower with concomitant procedures | 0.54 (0.42–0.69) | P < 0.01 | |
| Vascular complications · in-hospital · lower with concomitant procedures | 0.67 (0.47–0.94) | P = 0.02 | |
| 0.512Adjusted odds ratio (log scale) |
Original publication
Concomitant vs sequential atrial fibrillation ablation and left atrial appendage occlusion. Heart Rhythm. Published 28 August 2026. doi:10.1016/j.hrthm.2026.08.040
Summarised from the published abstract; every number is checked against it