Feasibility of Left Atrial Appendage Occlusion for Left Atrial Appendage Thrombus in Patients With Persistent Atrial Fibrillation

Oh Hyun Lee, Jung Sun Kim, Hui Nam Pak, Geu Ru Hong, Chi Young Shim, Jae Sun Uhm, In Jeong Cho, Boyoung Joung, Cheol Woong Yu, Hyun Jong Lee, Woong Chol Kang, Eun Seok Shin, Rak kyeong Choi, Do Sun Lim, Yangsoo Jang

Research output: Contribution to journalArticle

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Abstract

This study sought to investigate the safety of percutaneous left atrial appendage (LAA) occlusion for stroke prevention in patients with nonvalvular atrial fibrillation who have LAA thrombus. From October 2010 to October 2016, LAA occlusions were performed in facilities within a Korean multicenter registry in patients without (n = 132) or with (n = 10) LAA thrombus (detected during preprocedural assessments). The incidences of periprocedural complications, including stroke, pericardial tamponade, major bleeding, and device embolization, were assessed and compared between the groups. The incidence of periprocedural complications was not significantly different between patients with and without LAA thrombus (0% vs 5% [6 of 132]; p = 0.49). During the mean 23.2 ± 17.5-month follow-up duration, 7 major adverse cardiac events occurred (1 cardiovascular death, 6 ischemic strokes), but overall event rates were not significantly different between the groups (14% vs 9%; p = 0.47). In conclusion, percutaneous LAA occlusion in nonvalvular atrial fibrillation patients with LAA thrombus may be a safe and feasible alternative to anticoagulation in select patients at a high risk of bleeding or contraindication to anticoagulation, or in whom anticoagulation failed to prevent stroke.

Original languageEnglish
Pages (from-to)1534-1539
Number of pages6
JournalAmerican Journal of Cardiology
Volume121
Issue number12
DOIs
Publication statusPublished - 2018 Jun 15

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Atrial Appendage
Atrial Fibrillation
Thrombosis
Stroke
Hemorrhage
Cardiac Tamponade
Incidence
Registries
Safety
Equipment and Supplies

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Lee, Oh Hyun ; Kim, Jung Sun ; Pak, Hui Nam ; Hong, Geu Ru ; Shim, Chi Young ; Uhm, Jae Sun ; Cho, In Jeong ; Joung, Boyoung ; Yu, Cheol Woong ; Lee, Hyun Jong ; Kang, Woong Chol ; Shin, Eun Seok ; Choi, Rak kyeong ; Lim, Do Sun ; Jang, Yangsoo. / Feasibility of Left Atrial Appendage Occlusion for Left Atrial Appendage Thrombus in Patients With Persistent Atrial Fibrillation. In: American Journal of Cardiology. 2018 ; Vol. 121, No. 12. pp. 1534-1539.
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Feasibility of Left Atrial Appendage Occlusion for Left Atrial Appendage Thrombus in Patients With Persistent Atrial Fibrillation. / Lee, Oh Hyun; Kim, Jung Sun; Pak, Hui Nam; Hong, Geu Ru; Shim, Chi Young; Uhm, Jae Sun; Cho, In Jeong; Joung, Boyoung; Yu, Cheol Woong; Lee, Hyun Jong; Kang, Woong Chol; Shin, Eun Seok; Choi, Rak kyeong; Lim, Do Sun; Jang, Yangsoo.

In: American Journal of Cardiology, Vol. 121, No. 12, 15.06.2018, p. 1534-1539.

Research output: Contribution to journalArticle

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AU - Jang, Yangsoo

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AB - This study sought to investigate the safety of percutaneous left atrial appendage (LAA) occlusion for stroke prevention in patients with nonvalvular atrial fibrillation who have LAA thrombus. From October 2010 to October 2016, LAA occlusions were performed in facilities within a Korean multicenter registry in patients without (n = 132) or with (n = 10) LAA thrombus (detected during preprocedural assessments). The incidences of periprocedural complications, including stroke, pericardial tamponade, major bleeding, and device embolization, were assessed and compared between the groups. The incidence of periprocedural complications was not significantly different between patients with and without LAA thrombus (0% vs 5% [6 of 132]; p = 0.49). During the mean 23.2 ± 17.5-month follow-up duration, 7 major adverse cardiac events occurred (1 cardiovascular death, 6 ischemic strokes), but overall event rates were not significantly different between the groups (14% vs 9%; p = 0.47). In conclusion, percutaneous LAA occlusion in nonvalvular atrial fibrillation patients with LAA thrombus may be a safe and feasible alternative to anticoagulation in select patients at a high risk of bleeding or contraindication to anticoagulation, or in whom anticoagulation failed to prevent stroke.

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