Left atrial appendage occlusion in atrial fibrillation after intracranial hemorrhage
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Left atrial appendage occlusion in atrial fibrillation after intracranial hemorrhage. / Horstmann, Solveig; Zugck, Christian; Krumsdorf, Ulrike; Rizos, Timolaos; Rauch, Geraldine; Geis, Nicolas; Hardt, Stefan; Veltkamp, Roland.
In: NEUROLOGY, Vol. 82, No. 2, 14.01.2014, p. 135-138.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Left atrial appendage occlusion in atrial fibrillation after intracranial hemorrhage
AU - Horstmann, Solveig
AU - Zugck, Christian
AU - Krumsdorf, Ulrike
AU - Rizos, Timolaos
AU - Rauch, Geraldine
AU - Geis, Nicolas
AU - Hardt, Stefan
AU - Veltkamp, Roland
PY - 2014/1/14
Y1 - 2014/1/14
N2 - OBJECTIVE: To evaluate the safety and feasibility of percutaneous left atrial appendage occlusion (LAAO) in patients with atrial fibrillation (AF) and previous intracranial hemorrhage (ICH).METHODS: In an explorative, prospective, single-center, observational study, LAAO was performed in patients with previous ICH and AF using the Amplatzer Cardiac Plug device. Risks of ischemic strokes and hemorrhagic complications were estimated using the CHA2DS2Vasc score and the HAS-BLED score. Before and 1, 6, 12, and 24 months after the procedure, clinical status and complications were recorded. Major complications were predefined as periprocedural stroke, death, pericardial effusion, and device embolism.RESULTS: LAAO was performed in 20 patients. Based on CHA2DS2Vasc score (mean 4.5 ± 1.4) and HAS-BLED score (mean 4.7 ± 1.0), annual risks of stroke and hemorrhagic complications were 4.0%-6.7% and 8.7%-12.5%, respectively. No patient had a procedure-related complication. Minor postprocedural complications were observed in 4/20 patients (2 inguinal hematoma, 1 self-limiting asystole, and 1 thrombus formation on device). No ischemic or hemorrhagic stroke occurred during a mean follow-up of 13.6 ± 8.2 months.CONCLUSIONS: In this first study of LAAO in patients with previous ICH, LAAO appears feasible and safe. A larger, controlled trial is needed to assess the efficacy and safety of the procedure compared to other preventive measures.CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that in patients with a history of previous ICH and AF, percutaneous LAAO is safe and feasible.
AB - OBJECTIVE: To evaluate the safety and feasibility of percutaneous left atrial appendage occlusion (LAAO) in patients with atrial fibrillation (AF) and previous intracranial hemorrhage (ICH).METHODS: In an explorative, prospective, single-center, observational study, LAAO was performed in patients with previous ICH and AF using the Amplatzer Cardiac Plug device. Risks of ischemic strokes and hemorrhagic complications were estimated using the CHA2DS2Vasc score and the HAS-BLED score. Before and 1, 6, 12, and 24 months after the procedure, clinical status and complications were recorded. Major complications were predefined as periprocedural stroke, death, pericardial effusion, and device embolism.RESULTS: LAAO was performed in 20 patients. Based on CHA2DS2Vasc score (mean 4.5 ± 1.4) and HAS-BLED score (mean 4.7 ± 1.0), annual risks of stroke and hemorrhagic complications were 4.0%-6.7% and 8.7%-12.5%, respectively. No patient had a procedure-related complication. Minor postprocedural complications were observed in 4/20 patients (2 inguinal hematoma, 1 self-limiting asystole, and 1 thrombus formation on device). No ischemic or hemorrhagic stroke occurred during a mean follow-up of 13.6 ± 8.2 months.CONCLUSIONS: In this first study of LAAO in patients with previous ICH, LAAO appears feasible and safe. A larger, controlled trial is needed to assess the efficacy and safety of the procedure compared to other preventive measures.CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that in patients with a history of previous ICH and AF, percutaneous LAAO is safe and feasible.
KW - Aged
KW - Aged, 80 and over
KW - Atrial Appendage
KW - Atrial Fibrillation
KW - Feasibility Studies
KW - Female
KW - Humans
KW - Intracranial Hemorrhages
KW - Male
KW - Middle Aged
KW - Postoperative Complications
KW - Prospective Studies
KW - Stroke
KW - Therapeutic Occlusion
KW - Treatment Outcome
KW - Journal Article
KW - Observational Study
U2 - 10.1212/WNL.0000000000000022
DO - 10.1212/WNL.0000000000000022
M3 - SCORING: Journal article
C2 - 24319042
VL - 82
SP - 135
EP - 138
JO - NEUROLOGY
JF - NEUROLOGY
SN - 0028-3878
IS - 2
ER -