Left atrial appendage occlusion in an older population cohort

• Published in: Irish journal of medical science 2023-12, Vol.192 (6), p.2707-2712
• Main Authors: Killian, Michael, O’Regan, James, Torre, Ruth, O’ Sullivan, Crochan J.
• Format: Article
• Language: English
• Subjects: Family Medicine; General Practice; Internal Medicine; Medicine; Medicine & Public Health; Original Article
• ISSN: 0021-1265; 1863-4362
• DOI: 10.1007/s11845-023-03346-1

Background Atrial fibrillation is the most common cardiac arrhythmia and is a major risk factor for stroke, with an incidence rate of 4–5% per year. The use of DOACs is recommended for specific patient populations however the risk of bleeding commonly precludes their use. Left atrial appendage occlusion is a relatively novel procedure recommended for such patients. We set out to analyse the initial success and safety of this procedure in a single site. Results Twenty patients were included in the study with an average age of 81 years. Seventy percent ( n  = 14) were male. Ninety percent ( n  = 18) had a history of major bleeding, an absolute contraindication to anticoagulation. The mean CHADS2VaSc and HASBLED scores were 4.75 and 3.7, respectively. The technical success rate was 95% comparable with existing data. The procedural success rate in our study was 80%. The most frequent complication was cardiac tamponade, occurring in 10% of cases. Conclusion We report lower technical success and procedural success rates in an older population cohort than historically studied, 90% of whom had an absolute contraindication to oral anticoagulation, with higher CHADS2VaSc and HASBLED scores than commonly studied.