Mid-term outcomes of concomitant left atrial appendage closure and catheter ablation for non-valvular atrial fibrillation: a multicenter registry
To investigate the safety and midterm outcome of concomitant left atrial appendage (LAA) closure and catheter ablation (CA) as a one-stage hybrid procedure for non-valvular atrial fibrillation (AF) in a multicenter registry. A total of 50 consecutive patients with symptomatic drug-resistant non-valvular AF with CHA2DS2-VASc score ≥ 2 and contraindications for antithrombotic therapy were included in the prospectively established LAA closure registry, and underwent concomitant LAA closure (48 for WATCHMAN and 2 for ACP) and CA procedure (40 for radiofrequency and 10 for cryoballoon CA). Two cardiac tamponades, one peripheral vascular complications and one mild air embolism were observed during perioperative period. After mean follow-up of 20.2 ± 11.5 months, 18 (36%) patients presented with atrial arrhythmia relapse and 45 (91.8%) patients presented with complete sealing; furthermore, there were two transient ischemic attacks and one ischemic stroke under an off-oral anticoagulant situation, respectively. Concomitant CA and LAA closure as a one-stage hybrid procedure might be feasible and potentially decrease costs in patients with symptomatic non-valvular AF with high stroke risk and contraindication to antithrombotic treatment, and as safe as LAA closure procedure only during the perioperative period. However, it was necessary to further validate the mid-term safety.
KeywordsAtrial fibrillation Left atrial appendage closure Catheter ablation Concomitant
Left atrial appendage
Left ventricular ejection fraction
Amplatzer cardiac plug
Transient ischemic attack
Special thanks to Xuan Jiang M.D. for the statistical analysis to this article and David Cushley M.D. Ph.D. for language editing.
This work was supported by National Nature Science Foundation of China (no. 81370295), Science and Technology Program of Guangdong Province, China (no. 2017A020215054), Investigator sponsored research Grant from Boston scientific (IRF no. 20161216001), Science and Technology Planning of Guangzhou City, China (no. 2014B070705005).
Compliance with ethical standards
Conflict of interest
Prof. Shu-lin Wu received research grants from Boston scientific and Biosense Webster. No financial disclosures for the other author.
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