TY - JOUR
T1 - Left atrial appendage closure-indications, techniques, and outcomes: results of the European Heart Rhythm Association Survey
AU - Pison, Laurent
AU - Potpara, Tatjana S.
AU - Chen, Jian
AU - Larsen, Torben B.
AU - Bongiorni, Maria Grazia
AU - Blomstrom-Lundqvist, Carina
PY - 2015/4/1
Y1 - 2015/4/1
N2 - The purpose of this EP Wire was to assess the indications, techniques, and outcomes of left atrial appendage occlusion (LAAO) in Europe. Thirty-three European centres, all members of the European Heart Rhythm Association electrophysiology (EP) research network, responded to this survey by completing the questionnaire. The major indication for LAAO (94%) was the prevention of stroke in patients at high thromboembolic risk (CHA2DS2-VASc >= 2) and contraindications to oral anticoagulants (OACs). Twenty-one (64%) of the responding centres perform LAAO in their own institution and 80% implanted 30 or less LAAO devices in 2014. Two-dimensional transoesophageal echocardiography was the preferred imaging technique to visualize LAA before, during, and after LAAO in 79, 58, and 62% of the participating centres, respectively. Following LAAO, 49% of the centres prescribe vitamin K antagonists or novel OACs. Twenty-five per cent of the centres combine LAAO with pulmonary vein isolation. The periprocedural complications included death (range, 0-3%), ischaemic or haemorrhagic stroke (0-25%), tamponade (0-25%), and device embolization (0-20%). In conclusion, this EP Wire has demonstrated that LAAO is most commonly employed in patients at high thrombo-embolic risk in whom OAC is contraindicated. The technique is not yet very widespread and the complication rates remain significant.
AB - The purpose of this EP Wire was to assess the indications, techniques, and outcomes of left atrial appendage occlusion (LAAO) in Europe. Thirty-three European centres, all members of the European Heart Rhythm Association electrophysiology (EP) research network, responded to this survey by completing the questionnaire. The major indication for LAAO (94%) was the prevention of stroke in patients at high thromboembolic risk (CHA2DS2-VASc >= 2) and contraindications to oral anticoagulants (OACs). Twenty-one (64%) of the responding centres perform LAAO in their own institution and 80% implanted 30 or less LAAO devices in 2014. Two-dimensional transoesophageal echocardiography was the preferred imaging technique to visualize LAA before, during, and after LAAO in 79, 58, and 62% of the participating centres, respectively. Following LAAO, 49% of the centres prescribe vitamin K antagonists or novel OACs. Twenty-five per cent of the centres combine LAAO with pulmonary vein isolation. The periprocedural complications included death (range, 0-3%), ischaemic or haemorrhagic stroke (0-25%), tamponade (0-25%), and device embolization (0-20%). In conclusion, this EP Wire has demonstrated that LAAO is most commonly employed in patients at high thrombo-embolic risk in whom OAC is contraindicated. The technique is not yet very widespread and the complication rates remain significant.
KW - Atrial fibrillation
KW - Stroke
KW - Anticoagulation
KW - Left atrial appendage
KW - Occluder
KW - Outcome
KW - EHRA survey
KW - EP wire
U2 - 10.1093/europace/euv069
DO - 10.1093/europace/euv069
M3 - Article
C2 - 25833883
SN - 1099-5129
VL - 17
SP - 642
EP - 646
JO - EP Europace
JF - EP Europace
IS - 4
ER -