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. 2022 Nov 4;11(21):6548.
doi: 10.3390/jcm11216548.

Not to Rush-Laboratory Parameters and Procedural Complications in Patients Undergoing Left Atrial Appendage Closure

David Zweiker  1   2 , Lukas Fiedler  3 , Gabor G Toth  1 , Andreas Strouhal  4 , Georg Delle-Karth  4 , Guenter Stix  5 , Harald Gabriel  5 , Ronald K Binder  6 , Martin Rammer  6 , Michael Pfeffer  3 , Paul Vock  7 , Brigitte Lileg  7 , Clemens Steinwender  8 , Kurt Sihorsch  8 , Florian Hintringer  9 , Silvana Mueller  9 , Fabian Barbieri  9   10 , Martin Martinek  11 , Wolfgang Tkalec  11 , Nicolas Verheyen  1 , Klemens Ablasser  1 , Andreas Zirlik  1 , Daniel Scherr  1   12
Affiliations

Not to Rush-Laboratory Parameters and Procedural Complications in Patients Undergoing Left Atrial Appendage Closure

David Zweiker et al. J Clin Med. .

Abstract

Background: As a preventive procedure, minimizing periprocedural risk is crucially important during left atrial appendage closure (LAAC). Methods: We included consecutive patients receiving LAAC at nine centres and assessed the relationship between baseline characteristics and the acute procedural outcome. Major procedural complications were defined as all complications requiring immediate invasive intervention or causing irreversible damage. Logistic regression was performed and included age and left-ventricular function. Furthermore, the association between acute complications and long-term outcomes was evaluated. Results: A total of 405 consecutive patients with a median age of 75 years (37% female) were included. 47% had a history of stroke. Median CHA2DS2-VASc score was 4 (interquartile range, 3−5) and the median HAS-BLED score was 3 (2−4). Major procedural complications occurred in 7% of cases. Low haemoglobin (OR 0.8, 95% CI 0.65−0.99 per g/dL, p = 0.040) and end-stage kidney disease (OR 13.0, CI 2.5−68.5, p = 0.002) remained significant in multivariate analysis. Anaemia (haemoglobin < 12 and < 13 g/dL in female and male patients) increased the risk of complications 2.2-fold. Conclusions: The major complication rate was low in this high-risk patient population undergoing LAAC. End-stage kidney disease and low baseline haemoglobin were independently associated with a higher major complication rate.

Keywords: atrial fibrillation; complications; dialysis; haemoglobin; left atrial appendage closure.

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Conflict of interest statement

G.G.T: consulting fees from Abbott, Medtronic, Terumo, and Biotronik; D.Z.: consulting fees from Daiichi Sankyo, unrestricted grant from Boston Scientific; F.B.: grants from Boston Scientific and Abbott Laboratories, consulting fees from Boston Scientific, speaker honoraria and travel support from Daichii Sankyo. R.K.B.: proctor for Boston Scientific, speaker fees from Abbott, and travel support from Boston Scientific and Abbott. All remaining authors report no conflict of interest whatsoever.

Figures

Figure 1
Figure 1
Patient count, minor complications (grey dot), major complications (grey triangle), and periprocedural mortality (black cross) stratified by centre.
Figure 2
Figure 2
One-year mortality in patients with vs. without major complications.
See this image and copyright information in PMC

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