Transcatheter left atrial appendage closure for stroke prevention in atrial fibrillation with Amplatzer cardiac plug: the Belgian Registry

J. Kefer; P. Vermeersch; W. Budts; T. Depotter; A. Aminian; E. Benit; F. Stammen

Document Details :

Title: Transcatheter left atrial appendage closure for stroke prevention in atrial fibrillation with Amplatzer cardiac plug: the Belgian Registry
Author(s): J. Kefer , P. Vermeersch , W. Budts , T. Depotter , A. Aminian , E. Benit , F. Stammen
Journal: Acta Cardiologica
Volume: 68 Issue: 6 Date: 2013
Pages: 551-558
DOI: 10.2143/AC.68.6.8000001

Abstract :
Aims: The aim of the present study was to evaluate the procedural feasibility, the safety and the 1-year outcome following left atrial appendage (LAA) closure using the Amplatzer cardiac plug (ACP) in Belgium.
Methods and results: Data were prospectively collected among 90 consecutive patients, undergoing LAA closure with an ACP in 7 Belgian centres between June 2009 and September 2012. The patients (56 males, 74 ± 8 years) were at high risk for stroke (CHA₂DS₂-VASc = 4.4 ± 1.8) and bleeding (HAS-BLED = 3.3 ± 1.3). Technical success was obtained in all but one patient and procedural success was 95%. Procedural major adverse events (MAE) were 3 tamponades resulting in death in one case. Minor complications were 3 insignificant pericardial effusions, 2 transient myocardial ischaemia due to air embolism and 1 femoral pseudoaneurysm. At 1-y follow-up, there were 4 deaths, 2 minor strokes, 1 tamponade and 1 myocardial infarction. Overall survival was 94% and freedom from MAE was 88%. In our population, the expected annual stroke risk according to the CHA₂DS₂-VASc score was 5.08%, while the observed stroke rate was 2.14%/year.
Conclusions:The Belgian registry shows that LAA closure using the ACP device is feasible and safe. At 1-y follow-up, the observed stroke rate was 2.14%/year, less than predicted by the CHA₂DS₂-VASc score. Longer follow-up is needed to evaluate the long-term safety and its efficacy in reducing stroke.