Five-Year Outcomes and Cardiac Remodeling Following Left Atrial Appendage Occlusion
Baoxin Liu,1,* Jiachen Luo,1,* Mengmeng Gong,1 Zhiqiang Li,1 Beibei Shi,1 Xingxu Zhang,1 Xinqiang Han,2 Yidong Wei1 1Department of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China; 2Electrophysiology and Arrh...
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| Formato: | article |
| Lenguaje: | EN |
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Dove Medical Press
2021
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| Acceso en línea: | https://doaj.org/article/1caa4640eb90412090b7653ac44a8f09 |
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| Sumario: | Baoxin Liu,1,* Jiachen Luo,1,* Mengmeng Gong,1 Zhiqiang Li,1 Beibei Shi,1 Xingxu Zhang,1 Xinqiang Han,2 Yidong Wei1 1Department of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China; 2Electrophysiology and Arrhythmia Services, Reid Health, Indiana University School of Medicine, Richmond, IN, 47374, USA*These authors contributed equally to this workCorrespondence: Yidong WeiDepartment of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, 301 Middle Yanchang Road, Jingan District, Shanghai, People’s Republic of ChinaTel +86-021-66307249Fax +86-021-66301771Email ywei@tongji.edu.cnPurpose: LAAO has been an alternative therapy to oral anticoagulants (OACs) for stroke prophylaxis in patients with nonvalvular atrial fibrillation (NVAF) with elevated CHA2DS2-Vasc score, but the long-term outcomes of LAAO and its impacts on cardiac electrical and mechanical remodeling remain to be learned. We aimed to describe the impact of left atrial appendage occlusion (LAAO) on atrial remodeling and cardiovascular outcomes within 5-year follow-up.Patients and Methods: A total of 107 patients with nonvalvular atrial fibrillation (NVAF) undergoing LAAO in the Shanghai Tenth People’s Hospital between January 2014 and July 2017 were included. All participants were followed for ECG, transthoracic echocardiography (TTE), and clinical outcomes (including cardiovascular death, heart failure, ischemic stroke/systemic embolism, and pericardial effusion) at 6 and 12 months, and thereafter every 12 months after LAAO discharge until 5 years.Results: After LAAO, the left atrial diameter significantly increased at 6 months (48.6 ± 6.7 vs 46.5 ± 7.0 mm); heart rate decreased immediately after the procedure (78.5 ± 14.7 vs 85.3 ± 21.7 bpm) when compared with the pre-procedure level. The QTc interval prolongated to the highest value of 460.7 ± 46.8 ms at 6 months (pre-procedure level of 433.7± 49.0 ms). All these changes return to the pre-procedure level within the follow-up. For clinical outcomes, 51 patients suffered the composite of cardiovascular death (n=4, 3.7%), heart failure (n=25, 23.4%), ischemic stroke/systemic embolism (n=22, 20.6%), and pericardial effusion (n=26, 26.2%).Conclusion: LAAO did not change ECG or TTE characteristics and nonprocedure-related pericardial effusion is common during long-term follow-up. Further studies are warranted to investigate the optimal time frame of anticoagulation in patients undergoing LAAO.Keywords: atrial fibrillation, left atrial appendage occlusion, ECG, echocardiogram |
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