Real-world experience comparing two common left atrial appendage closure devices

被引:21
作者
Fastner, Christian
Hoffmann, Lea
Aboukoura, Mohamed
Behnes, Michael
Lang, Siegfried
Borggrefe, Martin
Akin, Ibrahim
Nienaber, Christoph A.
机构
[1] First Department of Medicine, University Medical Centre Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, European Centre for AngioScience (ECAS), DZHK (German Centre for Cardiovascular Research) partner site Heidelberg/Mannheim, Theo
[2] University Hospital Rostock, Department of Cardiology, Rostock
[3] Imperial College London, Royal Brompton Hospital, London,
[4] National Heart and Lung Institute, London
关键词
Atrial fibrillation; Left atrial appendage; Left atrial appendage closure device; Outcome; Comparison; ORAL ANTICOAGULATION; WATCHMAN DEVICE; FIBRILLATION; STROKE; WARFARIN; PREVENTION; RISK; CONTRAINDICATIONS; MANAGEMENT; OUTCOMES;
D O I
10.1186/s12872-018-0899-9
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: The interventional left atrial appendage closure (LAAC) is a guideline-conform alternative to oral anticoagulation (OAC) in non-valvular atrial fibrillation patients with OAC ineligibility. It was aimed to directly compare two contemporary devices in a real-world patient population. Methods: LAAC was conducted in two centres between 2010 and 2014 as well as between 2014 and 2017, respectively, in a standard fashion based on the specific manufacturer's recommendations. Baseline characteristics, procedural data and event rates during intra-hospital and 6 months follow-up were registered in a retrospective approach, and analysed in device-related groups. Results: A total of 189 patients presented for LAAC device implantation. Baseline characteristics were mostly evenly distributed. In 148 patients, a Watchman (TM) device (Boston Scientific, Natick, MA, USA) was successfully implanted, an Amplatzer (TM) Amulet (TM) (St. Jude Medical, St. Paul, MN, USA) in 34 patients (96.1 and 97.1%, respectively; p = 1.00). Major access site bleedings were more frequent in the Amplatzer (TM) Amulet (TM) group (8.9 versus 1.4%; p= 0. 046). No intra-hospital thromboembolic event was present During 6 months follow-up, peri-device leaks > 5 mm and thromboembolic events were uncommon (each p = n.s.). Conclusions: While procedural success was equally high with both contemporary devices, complications during follow-up were rare, and evenly distributed.
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页数:9
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共 26 条
[1]   Appendage obliteration to reduce stroke in cardiac surgical patients with atrial fibrillation [J].
Blackshear, JL ;
Odell, JA .
ANNALS OF THORACIC SURGERY, 1996, 61 (02) :755-759
[2]   Performance of the subcutaneous implantable cardioverter-defibrillator in patients with a primary prevention indication with and without a reduced ejection fraction versus patients with a secondary prevention indication [J].
Boersma, Lucas V. ;
Barr, Craig S. ;
Burke, Martin C. ;
Leon, Angel R. ;
Theuns, Dominic A. ;
Herre, John M. ;
Weiss, Raul ;
Kremers, Mark S. ;
Neuzil, Petr ;
Husby, Michael P. ;
Carter, Nathan ;
Stivland, Timothy M. ;
Gold, Michael R. .
HEART RHYTHM, 2017, 14 (03) :367-375
[3]   Implant success and safety of left atrial appendage closure with the WATCHMAN device: peri-procedural outcomes from the EWOLUTION registry [J].
Boersma, Lucas V. A. ;
Schmidt, Boris ;
Betts, Timothy R. ;
Sievert, Horst ;
Tamburino, Corrado ;
Teiger, Emmanuel ;
Pokushalov, Evgeny ;
Kische, Stephan ;
Schmitz, Thomas ;
Stein, Kenneth M. ;
Bergmann, MartinW. .
EUROPEAN HEART JOURNAL, 2016, 37 (31) :2465-2474
[4]   Impact of left atrial appendage morphology on indication and procedural outcome after interventional occlusion: results from the prospective multicentre German LAARGE registry [J].
Fastner, Christian ;
Nienaber, Christoph A. ;
Park, Jai-Wun ;
Brachmann, Johannes ;
Zeymer, Uwe ;
Goedde, Martin ;
Sievert, Horst ;
Geist, Volker ;
Lewalter, Thorsten ;
Krapivsky, Alexander ;
Kaeunicke, Matthias ;
Maier, Jens ;
Oezdemir, Belgin ;
Hochadel, Matthias ;
Schneider, Steffen ;
Senges, Jochen ;
Akin, Ibrahim .
EUROINTERVENTION, 2018, 14 (02) :151-157
[5]   Veno-venous double lasso pull-and-push technique for transseptal retrieval of an embolized Watchman occluder [J].
Fastner, Christian ;
Lehmann, Ralf ;
Behnes, Michael ;
Sartorius, Benjamin ;
Borggrefe, Martin ;
Akin, Ibrahim .
CARDIOVASCULAR REVASCULARIZATION MEDICINE, 2016, 17 (03) :206-208
[6]   Left Atrial Appendage Closure: A Single Center Experience and Comparison of Two Contemporary Devices [J].
Figini, Filippo ;
Mazzone, Patrizio ;
Regazzoli, Damiano ;
Porata, Giulia ;
Ruparelia, Neil ;
Giannini, Francesco ;
Stella, Stefano ;
Ancona, Francesco ;
Agricola, Eustachio ;
Sora, Nicoleta ;
Marzi, Alessandra ;
Aurelio, Andrea ;
Trevisi, Nicola ;
Della Bella, Paolo ;
Colombo, Antonio ;
Montorfano, Matteo .
CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, 2017, 89 (04) :763-772
[7]   Early results of first versus second generation Amplatzer occluders for left atrial appendage closure in patients with atrial fibrillation [J].
Gloekler, Steffen ;
Shakir, Samera ;
Doblies, Janosch ;
Khattab, Ahmed A. ;
Praz, Fabien ;
Guerios, Enio ;
Koermendy, Dezsoe ;
Stortecky, Stefan ;
Pilgrim, Thomas ;
Buellesfeld, Lutz ;
Wenaweser, Peter ;
Windecker, Stephan ;
Moschovitis, Aris ;
Jaguszewski, Milosz ;
Landmesser, Ulf ;
Nietlispach, Fabian ;
Meier, Bernhard .
CLINICAL RESEARCH IN CARDIOLOGY, 2015, 104 (08) :656-665
[8]   Prevalence of diagnosed atrial fibrillation in adults - National implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) study [J].
Go, AS ;
Hylek, EM ;
Phillips, KA ;
Chang, YC ;
Henault, LE ;
Selby, JV ;
Singer, DE .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2001, 285 (18) :2370-2375
[9]   Incidence of stroke in paroxysmal versus sustained atrial fibrillation in patients taking oral anticoagulation or combined antiplatelet therapy [J].
Hohnloser, Stefan H. ;
Pajitnev, Dimitri ;
Pogue, Janice ;
Healey, Jeff S. ;
Pfeffer, Marc A. ;
Yusuf, Salim ;
Connolly, Stuart J. .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2007, 50 (22) :2156-2161
[10]   Percutaneous closure of the left atrial appendage versus warfarin therapy for prevention of stroke in patients with atrial fibrillation: a randomised non-inferiority trial [J].
Holmes, David R. ;
Reddy, Vivek Y. ;
Turi, Zoltan G. ;
Doshi, Shephal K. ;
Sievert, Horst ;
Buchbinder, Maurice ;
Mullin, Christopher M. ;
Sick, Peter .
LANCET, 2009, 374 (9689) :534-542