Patients with intracranial bleeding and atrial fibrillation treated with left atrial appendage occlusion: Results from the Amplatzer Cardiac Plug registry.
| Title | Patients with intracranial bleeding and atrial fibrillation treated with left atrial appendage occlusion: Results from the Amplatzer Cardiac Plug registry. |
| Publication Type | Journal Article |
| Year of Publication | 2017 |
| Authors | Tzikas, A., Freixa X., Llull L., Gafoor S., Shakir S., Omran H., Giannakoulas G., Berti S., Santoro G., Kefer J., Aminian A., Gloekler S., Landmesser U., Nielsen-Kudsk J. Erik, Cruz-Gonzalez I., Kanagaratnam P., Nietlispach F., Ibrahim R., Sievert H., Schillinger W., Park J-W., Meier B., & Karvounis H. |
| Journal | Int J Cardiol |
| Volume | 236 |
| Pagination | 232-236 |
| Date Published | 2017 Jun 01 |
| ISSN | 1874-1754 |
| Keywords | Aged, Aged, 80 and over, Atrial Appendage, Atrial Fibrillation, Female, Follow-Up Studies, Humans, Intracranial Hemorrhages, Male, Prospective Studies, Registries, Retrospective Studies, Septal Occluder Device |
| Abstract | BACKGROUND: In patients with non-valvular atrial fibrillation (NVAF), intracranial bleeding (ICB) constitutes a very challenging situation in which the rate of both ischemic and hemorrhagic events is increased. In these patients, left atrial appendage occlusion (LAAO) might represent a very valid alternative.OBJECTIVES: To investigate the procedural safety and long-term outcome of patients undergoing LAAO therapy due to previous ICB.METHODS: Data from the Amplatzer Cardiac Plug multicenter registry on 1047 consecutive patients were analyzed. Patients with previous ICB as indication for LAAO were compared to patients with other indications.RESULTS: A total of 198 patients (18.9%) with previous ICB were identified. The CHADS-VASc score was similar (4.5±1.5 vs. 4.4±1.6, p=0.687) and the HAS-BLED score was higher in patients with previous ICB compared to those without (3.5±1.1 vs. 3.1±1.2, p<0.001). No significant differences in peri-procedural major adverse events were observed (2.5 vs 5.4%, p=0.1). Patients with previous ICB were more frequently on single acetylsalicylic acid therapy after LAAO (42.4% vs. 28.3%; p<0.001). With an average follow-up of 1.3years, the observed annual stroke/TIA rate (procedure and follow-up) for patients with previous ICB was 1.4% (75% relative risk reduction). The observed annual major bleeding rate (procedure and follow-up) for patients with previous ICB was 0.7% (89% relative risk reduction).CONCLUSIONS: In patients with NVAF and previous ICB, LAAO seemed to be a safe procedure and was associated with a significant reduction in stroke/TIA and a remarkably low frequency of major bleeding during follow-up. |
| DOI | 10.1016/j.ijcard.2017.02.042 |
| Alternate Journal | Int. J. Cardiol. |
| PubMed ID | 28215464 |
