Efficacy and safety of left atrial appendage closure in non-valvular atrial fibrillation in patients over 75  years

AbstractPercutaneous left atrial appendage closure (LAAC) may decrease risks of stroke and bleeding in elderly patients with non-valvular atrial fibrillation (NVAF), but it is still lacking of evidence. The present study aimed at evaluating the efficacy and safety of LAAC in patients with NVAF over 75  years. 351 patients with NVAF who underwent LAAC were retrospectively analyzed on the LAAC procedure characteristics and the clinical follow-up according to age (age ≥ 75 years or <  75 years). Out of the 351 patients, LAA were successfully closed in 347 patients (98.9%), including 341 with Watchman (WM) device and 6 with Amplatzer cardiac plug (ACP) device because of the WM device-incompatible anatomy. There were no significant differences in total LAAC success rate and pro cedure-related major complications within 7 days between the groups aged ≥ 75 years and aged <  75 years. After a nearly 2-year follow-up, there was an increased trend of major bleedings and all bleedings in the group aged ≥ 75 years, but there were no significant differences between both groups in all-cause death, cardiovascular death, stroke/TIA/system embolism, device thrombus an d device gap (>  5 mm). Kaplan–Meier analysis revealed that the relative risk of annual thromboembolic events between the observed values and the expected ones based on CHA2DS2-VASc score in the group aged  ≥ 75 years decreased more obviously (61.9% vs. 54.3%); however, the r...
Source: Heart and Vessels - Category: Cardiology Source Type: research