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

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 (CHA(2)DS(2)-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 CHA(2)DS(2)-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 CHA(2)DS(2)-VASc score. Longer follow-up is needed to evaluate the long-term safety and its efficacy in reducing stroke.