Arrhythmias & electrophysiologyResearch article
Patterns of antithrombotic treatment after left atrial appendage occlusion
- Optum claims data
Authors' conclusion
We observed heterogeneous patterns of post-LAAO antithrombotic therapy, with a substantial proportion of patients remaining on OAC or P2Y12 inhibitors beyond suggested durations, indicating an opportunity to improve practice and outcomes.
Study context
- Population
- Patients with atrial fibrillation (AF) aged ≥65 years undergoing first-time left atrial appendage occlusion (LAAO), Optum claims data (2015–2024)LAAO recipients (mean age 78, 47% female)
- Participants
- 16,304 patients
Main finding
As reported in the abstract
Antithrombotic treatment after implantation
Received an OAC
9844 (60%)
Received a P2Y12 inhibitor (either alone or with an OAC)
3499 (10%)
Further findings
Remaining on therapy · 6 months after the procedure
- Remained on OAC
- 6.5%
- Remained on P2Y12 inhibitors
- 39%
OAC duration among OAC users
- Median duration of use
- 54 days
- Discontinued by 6 months (of OAC users)
- 83%
Adherence to recommended protocol among OAC users with an imaging assessment by 45 days (n = 6856)
- Followed the recommended treatment protocol (of OAC users with imaging by 45 days)
- 39%
- Early OAC discontinuation (of OAC users with imaging by 45 days)
- 31%
- Continued OAC use beyond 6 months (of OAC users with imaging by 45 days)
- 11%
Prolonged OAC use
- Prolonged OAC use
- 2030 patients (12.5%)
Factors associated with prolonged OAC use
- black race, kidney disease, AF ablation, cardioversion, and longer pre-LAAO OAC use
Original publication
Patterns of antithrombotic treatment after left atrial appendage occlusion. Heart Rhythm. Published 17 April 2026. doi:10.1016/j.hrthm.2026.04.019
Summarised from the published abstract; every number is checked against it