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Left atrial appendage occlusion in an older population cohort

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Abstract

Background

Atrial fibrillation is the most common cardiac arrhythmia and is a major risk factor for stroke, with an incidence rate of 4–5% per year. The use of DOACs is recommended for specific patient populations however the risk of bleeding commonly precludes their use. Left atrial appendage occlusion is a relatively novel procedure recommended for such patients. We set out to analyse the initial success and safety of this procedure in a single site.

Results

Twenty patients were included in the study with an average age of 81 years. Seventy percent (n = 14) were male. Ninety percent (n = 18) had a history of major bleeding, an absolute contraindication to anticoagulation. The mean CHADS2VaSc and HASBLED scores were 4.75 and 3.7, respectively. The technical success rate was 95% comparable with existing data. The procedural success rate in our study was 80%. The most frequent complication was cardiac tamponade, occurring in 10% of cases.

Conclusion

We report lower technical success and procedural success rates in an older population cohort than historically studied, 90% of whom had an absolute contraindication to oral anticoagulation, with higher CHADS2VaSc and HASBLED scores than commonly studied.

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Abbreviations

EU:

European Union

DOAC:

Direct-acting oral anticoagulant

LAAO:

Left atrial appendage occlusion

ACP:

Amplatzer cardiac plug

MAE:

Major adverse event

VARC2:

Valve Academic Research Consortium 2

BARC:

Bleeding Academic Research Consortium

TOE:

Trans oesophageal echocardiogram

TIA:

Transient ischaemic attack

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Authors and Affiliations

  1. Bon Secours Hospital, College Road, Cork, Ireland

    Michael Killian, Ruth Torre & Crochan J. O’ Sullivan

  2. University College Cork, College Road, Cork, Ireland

    James O’Regan

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  1. Michael Killian
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  2. James O’Regan
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  3. Ruth Torre
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  4. Crochan J. O’ Sullivan
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Correspondence to Michael Killian.

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Ethical approval was granted by the Cork Research Ethics Committee and this study was performed in accordance with standards pertaining to the same.

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Killian, M., O’Regan, J., Torre, R. et al. Left atrial appendage occlusion in an older population cohort. Ir J Med Sci 192, 2707–2712 (2023). https://doi.org/10.1007/s11845-023-03346-1

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  • DOI: https://doi.org/10.1007/s11845-023-03346-1

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