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Transcatheter left atrial appendage occlusion for stroke prevention in patients with atrial fibrillation: results from the Belgian registry.

Title: Transcatheter left atrial appendage occlusion for stroke prevention in patients with atrial fibrillation: results from the Belgian registry.
Authors: Kefer, Joelle; Aminian, Adel; Vermeersch, Paul; de Potter, Tom; Stammen, Francis; Benit, Edouard; Budts, Werner; Missault, Luc; Drieghe, Benny; Buysschaert, Ian; Cornelis, Kristoff; Herzet, Jean-Manuel; Guedes, Antoine; Debbas, Nadia; Rivero, Maximo; Lempereur, Mathieu; Lochy, Stijn; Casado-Arroyo, Ruben; Laruelle, Christophe; Debruyne, Philippe; Ledent, Thierry
Contributors: UCL - SSS/IREC/MONT - Pôle Mont Godinne; UCL - (MGD) Service de cardiologie
Source: EuroIntervention, Vol. 13, no.13, p. 1603-1611 (2018)
Publication Year: 2018
Collection: DIAL@USL-B (Université Saint-Louis, Bruxelles)
Subject Terms: Aged; 80 and over; Atrial Appendage; Atrial Fibrillation; Belgium; Cardiac Catheterization; Echocardiography; Transesophageal; Female; Humans; Male; Middle Aged; Registries; Risk Factors; Stroke; Time Factors; Treatment Outcome
Description: This study aimed to assess the safety and efficacy at midterm follow-up of left atrial appendage occlusion (LAAO) using different devices, in real life in Belgium. Between June 2009 and November 2016, 457 consecutive patients (63% male, 75±12 yrs, CHA2DS2-VASc 4±0.6, HAS-BLED 3.5±0.7) undergoing LAAO were included. Technical success was 97.1%. There were 19 periprocedural major adverse events (4.1%) including three deaths (0.6%), nine tamponades (1.9%), four major bleedings (0.8%) and two device embolisations (0.4%). Among patients successfully implanted having a complete follow-up (672 patient-years, median follow-up 370 days), the actual annual stroke rate was 1.2%, lower than the expected stroke risk of 4% (70% reduction). The observed bleeding rate was 2%, while the calculated risk was 3.7% (46% reduction). Kaplan-Meier analysis showed a similar overall survival (93±2% and 87±3% versus 91±3% and 87±4%; p=0.35) and event-free survival (92±2% and 84±3% versus 88±3% and 80±5%; p=0.17) at one and two years, for the ACP/Amulet versus the WATCHMAN groups of patients, respectively. The data from the Belgian left atrial appendage occlusion registry suggest that the procedure is effective and relatively safe in a real-world setting, using either the WATCHMAN or the ACP/Amulet device.
Document Type: article in journal/newspaper
Language: English
Relation: boreal:261212; http://hdl.handle.net/2078.1/261212; info:pmid/28966159
DOI: 10.4244/EIJ-D-17-00076
Availability: http://hdl.handle.net/2078.1/261212; https://doi.org/10.4244/EIJ-D-17-00076
Rights: info:eu-repo/semantics/openAccess
Accession Number: edsbas.8C517CD8
Database: BASE