Left atrial appendage occlusion for stroke prevention in atrial fibrillation: multicentre experience with the AMPLATZER Cardiac Plug.
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.
EuroIntervention journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology