Safety of left atrial appendage closure in heart failure patients. (2nd October 2022)

• Record Type: Journal Article
• Authors: Das, Subrat; Lorente‐Ros, Marta; Wu, Lingling; Mehta, Davendra; Suri, Ranjit
• Is Part Of: Journal of cardiovascular electrophysiology. Volume 33:Number 12(2022)
• Page Start: 2578
• Page End: 2584
• Publication Date: 2022-10-02
• Subjects: heart failure -- left atrial appendage closure -- NIS -- safety -- WATCHMAN; Blood vessels -- Physiology -- Periodicals; Electrophysiology -- Periodicals; Heart -- Physiology -- Periodicals; 612.1
• DOI: 10.1111/jce.15682
• Languages: English
• ISSNs: 1045-3873

Abstract

Abstract: Introduction: Left atrial appendage closure (LAAC) is an intervention aimed at stroke prevention in nonvalvular atrial fibrillation (AF). There is a three‐fold increased risk of stroke in patients with concomitant presence of AF and heart failure (HF). While anticoagulation is effective, only 60% receive it. We aimed at studying the safety of LAAC in HF patients using a national all‐payer database. Methods: We queried the National Inpatient Sample for the year 2016–2018 for WATCHMAN device insertion using ICD 10 procedure codes. We divided the study population into HF and non‐HF groups. Outcomes were compared using appropriate statistical tests, p < .05 was considered significant. Results: 34 385 LAAC procedures were identified of which 8530 (24.8%) were done in patients with HF. The mean (SD) age of the study population was 76 (7.9) years and 42% were female. There was no difference in mean age between HF and non‐HF groups. Our findings indicate that there is no difference in inpatient mortality and cardiac complications between the HF and non‐HF groups. However, noncardiac complications including acute kidney injury and respiratory failure were higher in the HF group. Conclusion: LAAC appears to be a safe procedure in patients with HF. The study is limited by a short follow up period and long‐term follow‐up is required before definitive conclusions can be made.