Abstract
BackgroundPercutaneous left atrial appendage (LAA) closure is an alternative to oral anticoagulation (OAC) for atrial fibrillation (AF) patients with high thromboembolism risk, particularly with contraindications to OAC. The LAA itself could possess proarrhythmogenic properties. As patients undergoing LAA closure could be candidates for cardioversion or ablation, we aimed to evaluate AF disease progression following LAA closure and the outcome of patients undergoing a rhythm control strategy after the procedure.MethodsThe prospective multicenter French Nationwide Observational LAA Closure Registry (FLAAC) comprises 33 French interventional cardiology departments. Patients were included if they fulfilled the following criteria: history of non-valvular AF, successful LAA closure and long-term ECG follow-up.ResultsA total of 331 patients with successful LAA closure were enrolled in the study. Patients mean age was 75.4 ± 0.5 years. The study population was characterized by a high thromboembolic risk (CHA2DS2-VASc score: 4.5 ± 0.1) and frequent comorbidities. The median follow-up was 11.9 months. One hundred and nineteen (36.0%) patients were in sinus rhythm (SR) at baseline. Among SR patients, documented AF was observed in 16 (13.4%) patients whereas 15 (7.1%) patients in AF at baseline restored SR, at the end of follow up. Finally, only 13 patients (4%) underwent procedures to restore SR without complications during the follow-up.ConclusionsThe vast majority of patients undergoing LAA closure have the same AF status at baseline and one year after the index procedure. During the follow-up, a very small proportion (4%) of our population underwent procedures to restore SR without complications whatever the post-procedural antithrombotic strategy was.
Highlights
Percutaneous left atrial appendage (LAA) closure is an alternative to oral anticoagulation (OAC) for atrial fibrillation (AF) patients with high thromboembolism risk, with contraindications to OAC
Full list of author information is available at the end of the article
Numerous studies have demonstrated that LAA electrical isolation during persistent AF ablation can improve AF ablation outcomes [11,12,13]
Summary
Percutaneous left atrial appendage (LAA) closure is an alternative to oral anticoagulation (OAC) for atrial fibrillation (AF) patients with high thromboembolism risk, with contraindications to OAC. The left atrial appendage (LAA) is the main site for AFrelated thrombus formation, responsible for stroke [4, 5]. Lellouche et al BMC Cardiovasc Disord (2021) 21:227 for AF stroke prevention, namely percutaneous LAA closure. This technic has proven to reduce AF-related stroke and is an alternative to oral anticoagulants (OAC) [6,7,8], importantly in patients with definitive OAC contraindications [9]. The potential effect of LAA closure devices used for LAA closure on cardiac rhythm remains unknown
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