Long term outcomes after left atrial appendage closure with the LARIAT device-Stroke risk reduction over five years follow-up

PLoS One. 2018 Dec 19;13(12):e0208710. doi: 10.1371/journal.pone.0208710. eCollection 2018.

Abstract

Introduction: Left atrial appendage closure (LAAC) with LARIAT offers an alternative to oral anticoagulation (OAC) for patients with atrial fibrillation. The aim of this study was to present long-term clinical outcomes of LAAC in these patients (AF).

Material and methods: A prospective, single-center study was performed in 139 patients undergoing LAAC with Lariat. Thromboembolic events, severe bleeding and mortality rate were recorded. The reduction in risk of thromboembolism and bleeding after LAAC was calculated.

Results: The mean CHADS2-score was 1.8 ± 1.0, mean CHA2DS2-VASc score was 2.9 ± 1.6 and HAS-BLED score was 3.1 ± 1.1. After 428.4 patient-years of follow-up (mean 4.2±1.0 years), the thromboembolism rate was 0.6% with a calculated thromboembolism risk reduction of 81%. The severe bleeding rate was 0.8%; calculated bleeding risk reduction was 78%. The overall mortality rate was 1.6%.

Conclusions: Long-term outcomes show that LAAC with Lariat is a safe and effective treatment for stroke prevention and bleeding risk reduction in AF patients with a high level of underlying risk.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Atrial Appendage / surgery*
  • Female
  • Follow-Up Studies
  • Heart Diseases / epidemiology
  • Heart Diseases / surgery
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology
  • Prospective Studies
  • Stroke / epidemiology
  • Stroke / prevention & control*
  • Time Factors
  • Treatment Outcome
  • Young Adult

Grants and funding

This study is the results of the research grant No. UMO-2014/13/D/NZ5/01351 funded by the National Science Centre. KB is an recipient of the grant. URL:https://www.ncn.gov.pl/. This study is the results of the research grant No. UMO-2015/17/B/NZ5/00125 funded by the National Science Centre. KB is an recipient of the grant. URL:https://www.ncn.gov.pl/.