Combined left atrial appendage occlusion and catheter ablation procedure for left atrial arrhythmias: A real‐world, propensity‐matched analysis.

Autor:	Preisendörfer, Stefan, Ayub, Muhammad T., Sheth, Aakash, Jabbour, George Y., Singh, Madhurmeet, Patel, Chinmay P., Gada, Hemal, Bhonsale, Aditya, Dhande, Mehak, Estes, Nathan A., Kancharla, Krishna, Kliner, Dustin E., Makani, Amber, Naniwadekar, Aditi, Shalaby, Alaa, Singla, Virginia, Voigt, Andrew, Saba, Samir F., Jain, Sandeep K.
Předmět:	TRANSESOPHAGEAL echocardiography ANTICOAGULANTS MYOCARDIAL infarction LEFT heart atrium PATIENT safety T-test (Statistics) BODY mass index VENTRICULAR ejection fraction PULMONARY veins PROBABILITY theory FISHER exact test SEX distribution HYPERTENSION TREATMENT effectiveness RETROSPECTIVE studies DESCRIPTIVE statistics ANGIOGRAPHY AGE distribution LONGITUDINAL method CHRONIC kidney failure ATRIAL fibrillation ATRIAL arrhythmias COMBINED modality therapy ELECTRONIC health records MEDICAL records ACQUISITION of data INTERNATIONAL normalized ratio LEFT atrial appendage closure CATHETER ablation COMPARATIVE studies PLATELET aggregation inhibitors DATA analysis software CORONARY artery disease STROKE ALCOHOL drinking FLUOROSCOPY DIABETES NOSEBLEED DRUG utilization
Zdroj:	Journal of Cardiovascular Electrophysiology; Dec2024, Vol. 35 Issue 12, p2423-2431, 9p
Abstrakt:	Introduction: Real‐world studies comparing safety and efficacy of combined percutaneous left atrial appendage occlusion (LAAO) and catheter ablation (CA) to LAAO alone are limited. Methods: Patients from a large US hospital system undergoing combined LAAO and left‐atrial CA from 8/2020 to 2/2024 were retrospectively analyzed and compared to a control group undergoing LAAO alone. Controls were identified using a 1:2 propensity score match based on LAAO device type (Watchman FLX vs. Amulet), CHA2D2‐VASc and Hypertension, Abnormal renal/liver function, Stroke, Bleeding history or predisposition, Labile international normalized ratio [INR], Elderly, Drugs/alcohol (HAS‐BLED) scores and compared for safety, sealing performance and clinical outcomes at 6 months. Results: Patients were younger in the combined (n = 72) than in the control group (n = 144, 70.2 ± 7.3 vs. 76.7 ± 6.9 years, p < 0.001) but otherwise comparable with a mean CHA2D2‐VASc score of 4.2 ± 1.1 and 4.4 ± 1.2 (p = 0.26) and HAS‐BLED score of 2.2 ± 0.8 and 2.3 ± 0.7 (p = 0.34). Successful LAAO implantation rates were the same (95.8% vs. 95.8%, p = 0.99) with longer procedure times seen in the combined group (156.5 ± 53 vs. 56 ± 26 min, p < 0.001). Both major (1.4% vs. 2.1%, p = 0.72) and minor (27.8% vs. 19.4%, p = 0.17) in‐hospital complications were similar between the combined and control group, respectively. At 45 days, presence of peri‐device leak (18.3% vs. 30.4%, p = 0.07) and device related thrombosis (4.5% vs. 4.5%, p = 0.96) on transesophageal echocardiogram did not differ. Finally, all‐cause mortality (0% vs. 1.4%, p = 0.99), thromboembolic (0% vs. 0%, p = 0.99) and bleeding (6.1% vs. 4.4%, p = 0.73) events during follow‐up were comparable. Conclusion: This large, real‐world analysis indicates comparable safety and efficiency of combined LAAO and CA when compared with LAAO alone. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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