Outcomes of percutaneous left atrial appendage occlusion device implantation in atrial fibrillation patients based on underlying stroke risk.

Autor:	Messele LF; Division of Cardiovascular Medicine-Section of Cardiac Electrophysiology, University of California Davis School of Medicine, 4860 Y St. Suite 2800, Sacramento, CA 95817, USA., Khan MZ; Division of Cardiovascular Medicine, West Virginia University Heart & Vascular Institute, Morgantown, WV, USA., Darden D; Division of Cardiology, Kansas City Heart Rhythm Institute, Overland Park, KS, USA., Agarwal S; Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA., Krishan S; Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA., Pasupula DK; Division of Cardiovascular Medicine, MercyOne North Iowa Medical Center, Mason City, IA, USA., Ul Abideen Asad Z; Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA., Balla S; Division of Cardiovascular Medicine, West Virginia University Heart & Vascular Institute, Morgantown, WV, USA., Singh GD; Division of Cardiovascular Medicine-Section of Cardiac Electrophysiology, University of California Davis School of Medicine, 4860 Y St. Suite 2800, Sacramento, CA 95817, USA., Srivatsa UN; Division of Cardiovascular Medicine-Section of Cardiac Electrophysiology, University of California Davis School of Medicine, 4860 Y St. Suite 2800, Sacramento, CA 95817, USA., Munir MB; Division of Cardiovascular Medicine-Section of Cardiac Electrophysiology, University of California Davis School of Medicine, 4860 Y St. Suite 2800, Sacramento, CA 95817, USA.
Jazyk:	angličtina
Zdroj:	Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology [Europace] 2023 Apr 15; Vol. 25 (4), pp. 1415-1422.
DOI:	10.1093/europace/euad049
Abstrakt:	Aims: To determine outcomes in atrial fibrillation patients undergoing percutaneous left atrial appendage occlusion (LAAO) based on the underlying stroke risk (defined by the CHA2DS2-VASc score). Methods and Results: Data were extracted from the National Inpatient Sample for calendar years 2016-20. Left atrial appendage occlusion implantations were identified on the basis of the International Classification of Diseases, 10th Revision, Clinical Modification code of 02L73DK. The study sample was stratified on the basis of the CHA2DS2-VASc score into three groups (scores of 3, 4, and ≥5). The outcomes assessed in our study included complications and resource utilization. A total of 73 795 LAAO device implantations were studied. Approximately 63% of LAAO device implantations occurred in patients with CHA2DS2-VASc scores of 4 and ≥5. The crude prevalence of pericardial effusion requiring intervention was higher with increased CHA2DS2-VASc score (1.4% in patients with a score of ≥5 vs. 1.1% in patients with a score of 4 vs. 0.8% in patients with a score of 3, P < 0.01). In the multivariable model adjusted for potential confounders, CHA2DS2-VASc scores of 4 and ≥5 were found to be independently associated with overall complications [adjusted odds ratio (aOR) 1.26, 95% confidence interval (CI) 1.18-1.35, and aOR 1.88, 95% CI 1.73-2.04, respectively] and prolonged length of stay (aOR 1.18, 95% CI 1.11-1.25, and aOR 1.54, 95% CI 1.44-1.66, respectively). Conclusion: A higher CHA2DS2-VASc score was associated with an increased risk of peri-procedural complications and resource utilization after LAAO. These findings highlight the importance of patient selection for the LAAO procedure and need validation in future studies. Competing Interests: Conflict of interest: None declared. (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.)
Databáze:	MEDLINE
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