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. 2020 Oct 13;9(10):3274.
doi: 10.3390/jcm9103274.

Indications and Outcome in Patients Undergoing Left Atrial Appendage Closure-The Austrian LAAC Registry

David Zweiker  1   2 , Raphael Sieghartsleitner  1 , Lukas Fiedler  3 , Gabor G Toth  1 , Olev Luha  1 , Guenter Stix  4 , Harald Gabriel  4 , Paul Vock  5 , Brigitte Lileg  5 , Andreas Strouhal  6 , Geort Delle-Karth  6 , Michael Pfeffer  3 , Josef Aichinger  7 , Wolfgang Tkalec  7 , Clemens Steinwender  8 , Kurt Sihorsch  8 , Ronald K Binder  9 , Martin Rammer  9 , Fabian Barbieri  10 , Silvana Mueller  10 , Nicolas Verheyen  1 , Klemens Ablasser  1 , Andreas Zirlik  1 , Daniel Scherr  1   11
Affiliations

Indications and Outcome in Patients Undergoing Left Atrial Appendage Closure-The Austrian LAAC Registry

David Zweiker et al. J Clin Med. .

Abstract

Background: Complete real-world data on the indications and outcomes of left atrial appendage closure (LAAC) outside of clinical trials are rare. In this study, we stratified patients undergoing LAAC by indication groups.

Methods: This analysis of the national multicentre Austrian LAAC Registry comprised all patients that underwent LAAC up until 2018 at the currently active centres in Austria. The baseline characteristics, procedural details and outcomes between the following indication groups were compared: bleeding as an indication for LAAC ("bleeding" group) vs. thromboembolism despite oral anticoagulation (OAC; "thromboembolism" group) vs. an intolerance to OAC for reasons other than the above ("other" group).

Results: The analysis included 186 patients, with 59.7% in the "bleeding" group, 8.1% in the "thromboembolism" group and 32.2% in the "other" group. The CHADS2 score was the highest in the "thromboembolism" group and the HAS-BLED score was the highest in the "bleeding" group. The procedural outcomes were similar between groups (implantation success, 97.3%), with major complications occurring in 7.0% of patients. One-year survival free from stroke, bleeding or LAAC-associated hospitalisation was 83.9%, 90.0% and 81.4% in the "bleeding", "thromboembolism" and "other" groups, respectively (p = 0.891).

Conclusions: In routine clinical practice, LAAC was used in a heterogeneous patient population with atrial fibrillation (AF) and contraindication, inefficacy or intolerance to OAC. The long-term outcome was favourable in all groups.

Keywords: atrial fibrillation; bleeding; left atrial appendage; registry; stroke.

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Conflict of interest statement

H.G. serves as a consultant for Abbott. G.S. received speaker honoraria from Bayer, Biotronik and Boston Scientific. R.K.B. serves as proctor for Boston Scientific and has received grants from Abbott. D.S. received speaker honoraria from Boston Scientific. All other authors have nothing to disclose with respect to this publication.

Figures

Figure 1
Figure 1
Study flowchart. LAAC: left atrial appendage closure.
Figure 2
Figure 2
Indications of LAAC in the Austrian LAAC Registry. LAAC: left atrial appendage closure; OAC: oral anticoagulation.
Figure 3
Figure 3
Kaplan-Maier curves for the combined endpoint of death, stroke, bleeding or LAAC-related rehospitalisation.
See this image and copyright information in PMC

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