Left atrial appendage closure-indications, techniques, and outcomes: results of the European Heart Rhythm Association Survey

Laurent Pison*, Tatjana S. Potpara, Jian Chen, Torben B. Larsen, Maria Grazia Bongiorni, Carina Blomstrom-Lundqvist

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

53 Citations (Web of Science)

Abstract

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.
Original languageEnglish
Pages (from-to)642-646
JournalEP Europace
Volume17
Issue number4
DOIs
Publication statusPublished - 1 Apr 2015

Keywords

  • Atrial fibrillation
  • Stroke
  • Anticoagulation
  • Left atrial appendage
  • Occluder
  • Outcome
  • EHRA survey
  • EP wire

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