Arrhythmias & electrophysiology

Left atrial appendage occlusion in patients with end-stage renal disease: an individual patient-level meta-analysis

EuropacePublished Systematic review and individual patient-level meta-analysis

Authors' conclusion

LAAO represents a feasible option for thromboembolic prevention in patients with ESRD, although these patients have an increased risk of complications and bleeding.

Study context

Population
Patients with AF undergoing left atrial appendage occlusion (LAAO), with or without end-stage renal disease
Participants
24,127 patients · 17 studies
Comparison
LAAO in patients with end-stage renal disease (ESRD) vs without ESRD
  • ESRDn = 1,047
Methodological detailsaggregate and individual patient data meta-analyses
  • Aggregate and individual patient data meta-analyses

Pooled result

As reported in the abstract

Thromboembolic events during follow-up
ESRD vs No ESRDHazard ratio (95% CI)
stroke/TIA, individual patient data (7 studies, n = 4745, 268 ESRD)
1.22(0.66–2.26)
Aggregate data
IRR 1.44; P = 0.16

Safety

OutcomeHR (95% CI)P value
Major bleeding · individual patient data1.65 (1.01–2.69)
OutcomeESRDNo ESRDEstimateP value
Procedural complicationspooled rate 4% (95% CI 1–9%)Not reported in the abstractRR 2.23P = 0.02No ESRD: not reported in the abstract
Major bleeding · aggregate dataIRR 1.84P < 0.01

Original publication

Left atrial appendage occlusion in patients with end-stage renal disease: an individual patient-level meta-analysis. Europace. Published 29 August 2025. doi:10.1093/europace/euaf198

Summarised from the published abstract; every number is checked against it

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