当前位置： SCI文献检索 > Kardiologia Polska期刊下所有文献 > Percutaneous left atrial appendage occlusion procedures in patients with heart failure.

Percutaneous left atrial appendage occlusion procedures in patients with heart failure.

Abstract：

BACKGROUND:Atrial fibrillation (AF) is the most common supraventricular tachyarrhythmia. Percutaneous left atrial appendage occlusion (LAAO) may be considered for stroke prophylaxis in patients with nonvalvular AF (NVAF), especially in contraindications for oral anticoagulants (OAC) or high risk of bleeding. The data about implantation, safety, efficacy, and follow-up are limited. Moreover, there are no studies on patients with NVAF and heart failure with severe left ventricular systolic dysfunction (left ventricular ejection fraction [LVEF] ≤ 35%). AIM:To assess the safety, efficacy, and mid-term outcomes of LAAO procedures with Amplatzer Cardiac Plug (ACP) and Amplatzer Amulet device in patients with NVAF and heart failure with LVEF ≤ 35% (group I) and to perform a comparative analysis of the patients who had LAAO with NVAF and LVEF > 35%. METHODS:The analysis included 80 patients (group I: 19, group II: 61) with NVAF. The patients were enrolled for the study if they had: CHA2DS2VASc ≥ 2 and high risk of bleeding assessed in HAS-BLED (≥ 3) or less points in HAS-BLED but coexisting contraindications for OAC, or thromboembolic complications while using OAC. Time of follow-up was six months. RESULTS:In the studied population, the median CHA2DS2VASc score was 4 and the average HAS-BLED score was 3.2. Device implantation was successful in all patients from group I and in 59/61 patients from group II. The periprocedural clinical ef-ficacy (no thromboembolic complications) was 100% in group I and 98.4% in group II. Serious periprocedural complications (cardiac tamponade: 2.5%, device embolisation: 1.25%, unexplained death: 1.25%) occurred only in patients from group II (p = NS). The mid-term clinical efficacy was 100% in group I and 98.3% in group II (p = NS). During follow-up, one transient ischaemic attack and three deaths not related to the procedure occurred. CONCLUSIONS:Percutaneous LAAO is an effective and safe procedure in patients with NVAF and severe systolic heart failure. No significant periprocedural and mid-term differences, in terms of safety and efficacy, between the group with severe systolic heart failure (LVEF ≤ 35%) and the group without severe left ventricular systolic dysfunction (LVEF > 35%) were found.

journal_name

Kardiol Pol

journal_title

Kardiologia polska

authors

Szymała M,Streb W,Mitręga K,Podolecki T,Mencel G,Kukulski T,Kalarus Z

doi

10.5603/KP.a2017.0115

subject

Has Abstract

pub_date

2017-01-01 00:00:00

pages

868-876

issue

eissn

0022-9032

issn

1897-4279

pii

VM/OJS/KP/11116

journal_volume

pub_type

杂志文章

在线工具

Percutaneous left atrial appendage occlusion procedures in patients with heart failure.