TY - JOUR
T1 - Percutaneous left atrial appendage occlusion in patients with a cardiac implantable electronic device
AU - Staal, D. P.
AU - Maarse, M.
AU - Aarnink, E.
AU - Huijboom, M. F. M.
AU - Abeln, B. G. S.
AU - Rensing, B. J. M. W.
AU - Swaans, M. J.
AU - van Dijk, V. F.
AU - Boersma, L. V. A.
N1 - Funding Information: M. Maarse was supported by an educational grant from Boston Scientific. L. Boersma is a consultant for Boston Scientific and proctor for Abbott. M. Swaans reports proctoring fees for training/educational services to the Department of Cardiology from Boston Scientific and personal fees from Abbott. The other authors declared no conflict of interests. Publisher Copyright: © 2023, The Author(s).
PY - 2023
Y1 - 2023
N2 - Background: Left atrial appendage occlusion (LAAO) may be a viable option for stroke prevention in patients with non-valvular atrial fibrillation and a contraindication for oral anticoagulation. No evidence evaluating the safety of this procedure in patients with a cardiac implantable electronic device (CIED) exists. The aim of this study was to evaluate whether CIED function is affected by LAAO and to explore LAAO procedural characteristics and complications in patients with a CIED. Methods: This single-center cohort study included consecutive patients scheduled for percutaneous LAAO. Patients with a CIED prior to LAAO were selected and compared to the patients without CIED, concerning procedural characteristics and peri-procedural complications. In the group of patients with CIEDs, essential pacemaker integrity parameters were compared before and after the procedure to detect possible micro and macro lead displacements. Results: Thirty-one patients with CIED were scheduled for LAAO (age 73.7 ± 5.4 years, 65% males, CHA2DS2-VASc 4.3 ± 1.5, and HAS-BLED 3.3 ± 1.0). The 245 patients without CIED were younger, and HAS-BLED-score was slightly lower (69.4 ± 8.2 years, p < 0.001; 2.8 ± 1.0, p = 0.022). Patients without CIED more frequently underwent LAAO combined with catheter ablation (p = 0.002). All other procedural characteristics were comparable between both groups. No visible lead displacement was observed on chest X-ray after LAAO. Additionally, no differences in impedance, threshold, or intracardiac sensing in various CIED lead locations were found prior versus post LAAO. Conclusion: This study supports the feasibility and safety of LAAO in patients with a CIED.
AB - Background: Left atrial appendage occlusion (LAAO) may be a viable option for stroke prevention in patients with non-valvular atrial fibrillation and a contraindication for oral anticoagulation. No evidence evaluating the safety of this procedure in patients with a cardiac implantable electronic device (CIED) exists. The aim of this study was to evaluate whether CIED function is affected by LAAO and to explore LAAO procedural characteristics and complications in patients with a CIED. Methods: This single-center cohort study included consecutive patients scheduled for percutaneous LAAO. Patients with a CIED prior to LAAO were selected and compared to the patients without CIED, concerning procedural characteristics and peri-procedural complications. In the group of patients with CIEDs, essential pacemaker integrity parameters were compared before and after the procedure to detect possible micro and macro lead displacements. Results: Thirty-one patients with CIED were scheduled for LAAO (age 73.7 ± 5.4 years, 65% males, CHA2DS2-VASc 4.3 ± 1.5, and HAS-BLED 3.3 ± 1.0). The 245 patients without CIED were younger, and HAS-BLED-score was slightly lower (69.4 ± 8.2 years, p < 0.001; 2.8 ± 1.0, p = 0.022). Patients without CIED more frequently underwent LAAO combined with catheter ablation (p = 0.002). All other procedural characteristics were comparable between both groups. No visible lead displacement was observed on chest X-ray after LAAO. Additionally, no differences in impedance, threshold, or intracardiac sensing in various CIED lead locations were found prior versus post LAAO. Conclusion: This study supports the feasibility and safety of LAAO in patients with a CIED.
KW - Atrial fibrillation
KW - Cardiac implantable electronic device
KW - Implantable cardioverter defibrillator
KW - Left atrial appendage occlusion
KW - Pacemaker
KW - Stroke
UR - http://www.scopus.com/inward/record.url?scp=85149066976&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s10840-023-01512-0
DO - https://doi.org/10.1007/s10840-023-01512-0
M3 - Article
C2 - 36856972
SN - 1383-875X
JO - Journal of Interventional Cardiac Electrophysiology
JF - Journal of Interventional Cardiac Electrophysiology
ER -