Left atrial appendage occlusion for stroke prevention in atrial fibrillation: multicentre experience with the AMPLATZER Cardiac Plug.

Tzikas, Apostolos; Shakir, Samera; Gafoor, Sameer; Omran, Heyder; Berti, Sergio; Santoro, Gennaro; Kefer, Joelle; Landmesser, Ulf; Nielsen-Kudsk, Jens Erik; Cruz-Gonzalez, Ignacio; Sievert, Horst; Tichelbäcker, Tobias; Kanagaratnam, Prapa; Nietlispach, Fabian; Aminian, Adel; Kasch, Friederike; Freixa, Xavier; Danna, Paolo; Rezzaghi, Marco; Vermeersch, Paul; ... (2016). Left atrial appendage occlusion for stroke prevention in atrial fibrillation: multicentre experience with the AMPLATZER Cardiac Plug. EuroIntervention, 11(10), pp. 1170-1179. Europa Digital & Publishing 10.4244/EIJY15M01_06

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AIMS To investigate the safety, feasibility, and efficacy of left atrial appendage occlusion (LAAO) with the AMPLATZER Cardiac Plug (ACP) for stroke prevention in patients with atrial fibrillation (AF). METHODS AND RESULTS Data from consecutive patients treated in 22 centres were collected. A total of 1,047 patients were included in the study. Procedural success was 97.3%. There were 52 (4.97%) periprocedural major adverse events. Follow-up was complete in 1,001/1,019 (98.2%) of successfully implanted patients (average 13 months, total 1,349 patient-years). One-year all-cause mortality was 4.2%. No death at follow-up was reported as device-related. There were nine strokes (0.9%) and nine transient ischaemic attacks (0.9%) during follow-up. The annual rate of systemic thromboembolism was 2.3% (31/1,349 patient-years), which is a 59% risk reduction. There were 15 major bleedings (1.5%) during follow-up. The annual rate of major bleeding was 2.1% (28/1,349 patient-years), which is a 61% risk reduction. Patients with single LAAO on aspirin monotherapy or no therapy and longer follow-up had fewer cerebral and fewer bleeding events. CONCLUSIONS In this multicentre study, LAAO with the ACP showed high procedural success and a favourable outcome for the prevention of AF-related thromboembolism. Modification in antithrombotic therapy after LAAO may result in reduction of bleeding events.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Shakir, Samera and Meier, Bernhard

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1774-024X

Publisher:

Europa Digital & Publishing

Language:

English

Submitter:

Daria Vogelsang

Date Deposited:

15 Mar 2017 08:33

Last Modified:

15 Mar 2017 08:33

Publisher DOI:

10.4244/EIJY15M01_06

PubMed ID:

25604089

URI:

https://boris.unibe.ch/id/eprint/92576

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