Abstract 18185: Clinical Impact of Left Atrial Appendage Closure on the Incidence of Stroke, Bleeding and on Quality of Life in Patients With Atrial Fibrillation: A Standardized Single Center Registry
Introduction: We aimed to assess the impact of left atrial appendage closure (LAAC) on the incidence of cardiac mortality, stroke, bleeding and quality of life (QOL) in a standardized single center registry.
Methods: At our institution LAAC using the Watchman device has been recommended since 2010 in all patients (pt) with atrial fibrillation (AF) and bleeding events under oral anticoagulation therapy (OAC). Postprocedural antithrombotic therapy included aspirin for life, OAC or low molecular weight heparins (LMWH) for 45 days, followed by clopidogrel up to 6 months after LAAC. In pt with absolute contraindications against OAC, clopidogrel was started after LAAC and given for 6 months without OAC/LMWH. An ambulatory examination with transesophageal echo at 45 days and a standardized clinical follow-up (f/u) at 1 year including QOL assessment using a modified 17-questions AFEQT™ questionnaire were routinely performed.
Results: Ninety consecutive pt (52 males) aged between 53 - 90 years (74.3 ± 7, median 75) underwent LAAC between 2010 and 2013. The CHA2DS2VASc score ranged between 2 - 6 (4.1 ± 1.1, median 4) and the HAS-BLED score between 2 - 8 (4.4 ± 1.6, median 4). Confirmed history of stroke was present in 11 pt, of whom 9 had a non-chicken wing morphology of the appendage (p < 0.01). Procedural success was obtained in 89 of 90 pt, while 3 pt needed 2 occluders to fully close the LAA. Clinical f/u data and the modified AFEQT™ questionnaire, which was completed by 49 pt are shown in Tables 1 and 2.
Conclusions: In AF pt with high stroke and bleeding risk LAAC effectively reduced both bleeding complications and ischemic stroke and also significantly improved quality of life at 1-year follow-up.
Author Disclosures: T.C. Poerner: Research Grant; Modest; B Braun. Speakers Bureau; Modest; Bayer, Boehringer Ingelheim, B Braun, Pfizer, Abbott Vascular, Daiichi Sankyo, Elixir Medical. Consultant/Advisory Board; Modest; Boehringer Ingelheim. S. Wieg: None. B. Goebel: None. S. Otto: None. H.R. Figulla: None.
- © 2015 by American Heart Association, Inc.