scholarly journals Racial and ethnic differences in left atrial appendage occlusion wait time, complications, and periprocedural management

2021 ◽  
Author(s):  
Abdullah Haddad ◽  
Matthew Bocchese ◽  
Rebecca Garber ◽  
Brian O'Neill ◽  
George A. Yesenosky ◽  
...  
Keyword(s):  
Ethnic Differences ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Wait Time ◽  
Atrial Appendage ◽  
Racial And Ethnic Differences ◽  
Periprocedural Management ◽  
Left Atrial Appendage Occlusion

Abstract 16133: Racial and Ethnic Differences in Treatment and Outcomes of Left Atrial Appendage Occlusion in Patients With Atrial Fibrillation

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Abdullah Haddad ◽  
Rebecca Garber ◽  
Matthew Bocchese ◽  
George Yesenosky ◽  
Anuj Basil ◽  
...  
Keyword(s):  
Oral Anticoagulation ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Wait Time ◽  
Patient Characteristics ◽  
Atrial Appendage ◽  
Left Atrial Appendage Occlusion ◽  
Significant Difference ◽  
Procedural Complications ◽  
White Patients

Introduction: Non-white patients have been reported to face barriers to left atrial appendage occlusion (LAAO). Hypothesis: We hypothesized that white vs. non-white patients would have disparate wait times for and post-procedural treatment course after LAAO. Methods: We identified consecutive patients undergoing LAAO (Watchman TM ) at our institution between November 2015 - March 2020. In white vs. non-white patients, we compared patient characteristics, indications for LAAO, procedural wait time from index event (IE) and cardiology encounter to LAAO procedure, complications, post-procedure anticoagulation regimen, and adherence to 45-day post-procedural transesophageal echocardiogram (TEE). Results: Of 109 consecutive patients receiving LAAO implants, 45% were white (n = 49). White patients were less likely to have prior cerebral vascular accident (14% vs. 43%, p=0.001), heart failure (18% vs. 48%, p=0.001), and end stage renal disease (0% vs. 20%, p<0.001). White patients also had lower CHADS2VASc and HAS-BLED scores (4 vs. 4.8, p=0.006 and 3.5 vs. 4.2, p<0.001, respectively). The majority of both white and non-white patients underwent LAAO due to prior gastrointestinal bleed (66% vs. 76%, p=0.9). Non-white patients were more likely to be in poverty (55% vs. 15% p<0.001). There was no difference in median time from IE or initial cardiology encounter to LAAO procedure in whites vs. non-whites (10.5 vs. 13.7 months, p=0.9 and 1.9 vs 1.8 months p=0.6, respectively), and there was no significant difference in procedural complications, all of which were non-fatal pericardial effusions (4% vs. 5%, p=0.33). After adjusting for CHADS2VASc score, whites may have been more likely to be discharged on oral anticoagulation vs. dual anti-platelet therapy (OR 2.4, 95%CI [0.94-6] p=0.07). Adherence to post-procedural TEE was similar between groups (92% vs 90%, p=0.7). Conclusions: Whites and non-whites had similar indications for LAAO, procedural wait time, risk of procedural complications, and adherence to post-procedural TEE, despite a higher burden of co-morbidities. White patients may be more likely to be discharged on oral anticoagulation.

Rationale and trial design of the Left Atrial Appendage Occlusion Study (LAAOS III)

2014 ◽  
Vol 62 (S 01) ◽  
Author(s):  
W. Reents ◽  
A. Diegeler ◽  
J. Babin-Ebell ◽  
A. Böning ◽  
R.P. Whitlock
Keyword(s):  
Left Atrial ◽  
Trial Design ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Left Atrial Appendage Occlusion

scholarly journals Left Atrial Appendage Occlusion

2020 ◽  
Vol 12 (1) ◽  
pp. xiii
Author(s):  
Ranjan K. Thakur ◽  
Andrea Natale
Keyword(s):  
Left Atrial ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Left Atrial Appendage Occlusion

scholarly journals Double-blind, placebo-controlled randomised clinical trial to evaluate the effect of ASPIRIN discontinuation after left atrial appendage occlusion in atrial fibrillation: protocol of the ASPIRIN LAAO trial

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e044695
Author(s):  
Mu Chen ◽  
Qunshan Wang ◽  
Jian Sun ◽  
Peng-Pai Zhang ◽  
Wei Li ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Ethics Committee ◽  
Aspirin Therapy ◽  
Atrial Appendage ◽  
Control Group ◽  
Coronary Syndrome ◽  
Left Atrial Appendage Occlusion ◽  
Increased Risk

IntroductionIt is the common clinical practice to prescribe indefinite aspirin for patients with non-valvular atrial fibrillation (NVAF) post left atrial appendage occlusion (LAAO). However, aspirin as a primary prevention strategy for cardiovascular diseases has recently been challenged due to increased risk of bleeding. Therefore, aspirin discontinuation after LAAO in atrial fibrillation (ASPIRIN LAAO) trial is designed to assess the uncertainty about the risks and benefits of discontinuing aspirin therapy at 6 months postimplantation with a Watchman LAAO device in NVAF patients.Methods and analysisThe ASPIRIN LAAO study is a prospective, multicentre, randomised, double-blinded, placebo-controlled non-inferiority trial. Patients implanted with a Watchman device within 6 months prior to enrollment and without pre-existing conditions requiring long-term aspirin therapy according to current guidelines are eligible for participating the trial. Subjects will be randomised in a 1:1 allocation ratio to either the Aspirin group (aspirin 100 mg/day) or the control group (placebo) at 6 months postimplantation. A total of 1120 subjects will be enrolled from 12 investigational sites in China. The primary composite endpoint is stroke, systemic embolism, cardiovascular/unexplained death, major bleeding, acute coronary syndrome and coronary or periphery artery disease requiring revascularisation at 24 months. Follow-up visits are scheduled at 6 and 12 months and then every 12 months until 24 months after the last patient recruitment.Ethics and disseminationEthics approval was obtained from the Ethics Committee of Xinhua Hospital, Shanghai, China (reference number XHEC-C-2018-065-5). The protocol is also submitted and approved by the institutional Ethics Committee at each participating centre. Results are expected in 2024 and will be disseminated through peer-reviewed journals and presentations at national and international conferences.Trial registration numberNCT03821883.

Intraprocedural Hybrid Cardiac Computed Tomography for Left Atrial Appendage Occlusion

2021 ◽  
Vol 14 (16) ◽  
pp. 1852-1853
Author(s):  
Mahdi Veillet-Chowdhury ◽  
Stewart M. Benton ◽  
C. Anwar A. Chahal ◽  
James E. Harvey ◽  
Paul Tolerico ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Cardiac Computed Tomography ◽  
Atrial Appendage ◽  
Left Atrial Appendage Occlusion

Left Atrial Appendage Occlusion With the LAmbre Device: Initial Experience

2018 ◽  
Vol 71 (9) ◽  
pp. 755-756 ◽  
Author(s):  
Ignacio Cruz-González ◽  
Xavier Freixa ◽  
José Antonio Fernández-Díaz ◽  
José Carlos Moreno-Samos ◽  
Victoria Martín-Yuste ◽  
...  
Keyword(s):  
Left Atrial ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Initial Experience ◽  
Left Atrial Appendage Occlusion
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