Abstract 14567: Safety of Concomitant Percutaneous Left Atrial Appendage Occlusion Among Patients Undergoing Catheter Ablation for Atrial Fibrillation

Abstract

Background: The safety of concomitant percutaneous left atrial appendage occlusion procedure (LAAO) among patients undergoing catheter ablation (CA) for atrial fibrillation (AF) is unclear. This study aimed to evaluate the association between concomitant LAAO vs non-receipt LAAO with the risk of in-hospital complications and 30-day all-cause readmission among patients undergoing CA for AF. Methods: We performed a retrospective study using the Nationwide Readmission Database of the United States. The primary outcome was the in-hospital composite complications, which was defined as a composite of death, tamponade, hematoma, pneumothorax, and blood transfusion. The secondary outcome was the 30-day all-cause readmission. We performed a 1:10 propensity score (PS) matching analysis to compare the safety of performing and not performing LAAO on the same day of CA for AF. Logistic regression analysis was performed to evaluate the association between performing LAAO and the endpoints in the PS-matched cohort. Results: Among 25,834 patients (median age 70 years [62-78], 45% female) who underwent CA for AF between 2017 and 2019, 146 patients (0.6%) underwent LAAO on the same day. After the PS matching, a total of 1,515 patients (145 in the LAAO group and 1,370 in the non-LAAO group) were included in the comparative analysis. Concomitant LAAO procedure was not associated with higher risk of in-hospital complications (LAAO vs. non-LAAO; 10% vs. 7.9%; odds ratio [OR]; 1.35, 95% confidence interval [CI]; 0.76-2.38) and 30-day all-cause readmission following discharge (10% vs. 14%; OR; 0.71, 95% CI; 0.41-1.24). Conclusions: There was no significant difference in the in-hospital complications and 30-day all-cause readmission rates following LAAO and CA for AF compared to that of those who underwent CA for AF without LAAO.