Atrial fibrillation evolution and rhythm control strategy following left appendage closure: new insights from the prospective FLAAC registry

BMC Cardiovascular Disorders

Nicolas Lellouche¹  Julien Ternacle¹  Romain Gallet¹  David Hamon¹  Emmanuel Teiger¹  Jean-Sylvain Hermida²  Jean-Michel Juliard³  Tarvinder Dhanjal⁴  Raphaele Arrouasse⁵  Philippe Le Corvoisier⁵  Jean-Luc Pasquie⁶ 

[1] Cardiology Unit Henri Mondor University Hospital Paris XII;Department of Cardiac Arrhythmia, Picardie University Hospital;Department of Cardiology, Bichat Hospital, APHP, University Paris VII, DHU FIRE, Sorbonne Paris-Cité, INSERM U-1148;Department of Electrophysiology, University Hospital Coventry & Warwickshire;Inserm, CIC 1430, Henri Mondor University Hospital;Montpellier University Hospital, CNRS UMR9214-Inserm U1046–PHYMEDEXP;

关键词: Left atrial appendage closure;    Atrial fibrillation;    Cardioversion;    Ablation;   

DOI  :  10.1186/s12872-021-01994-8

来源: DOAJ

【 摘 要 】

Abstract Background Percutaneous left atrial appendage (LAA) closure is an alternative to oral anticoagulation (OAC) for atrial fibrillation (AF) patients with high thromboembolism risk, particularly with contraindications to OAC. The LAA itself could possess proarrhythmogenic properties. As patients undergoing LAA closure could be candidates for cardioversion or ablation, we aimed to evaluate AF disease progression following LAA closure and the outcome of patients undergoing a rhythm control strategy after the procedure. Methods The prospective multicenter French Nationwide Observational LAA Closure Registry (FLAAC) comprises 33 French interventional cardiology departments. Patients were included if they fulfilled the following criteria: history of non-valvular AF, successful LAA closure and long-term ECG follow-up. Results A total of 331 patients with successful LAA closure were enrolled in the study. Patients mean age was 75.4 ± 0.5 years. The study population was characterized by a high thromboembolic risk (CHA2DS2-VASc score: 4.5 ± 0.1) and frequent comorbidities. The median follow-up was 11.9 months. One hundred and nineteen (36.0%) patients were in sinus rhythm (SR) at baseline. Among SR patients, documented AF was observed in 16 (13.4%) patients whereas 15 (7.1%) patients in AF at baseline restored SR, at the end of follow up. Finally, only 13 patients (4%) underwent procedures to restore SR without complications during the follow-up. Conclusions The vast majority of patients undergoing LAA closure have the same AF status at baseline and one year after the index procedure. During the follow-up, a very small proportion (4%) of our population underwent procedures to restore SR without complications whatever the post-procedural antithrombotic strategy was.

【 授权许可】

Unknown