Atrial appendage closure in patients with heart failure and atrial fibrillation: industry‐independent single‐centre study

Saad, Mohammed; Osman, Mahmoud M.; Hasan‐Ali, Hosam; Ghany, Mohammed Abdel; Alsherif, Mohamad A; Risha, Osama; Sano, Makoto; Fink, Thomas; Heeger, Christian‐Hendrik; Vogler, Julia; Sciacca, Vanessa; Eitel, Charlotte; Stiermaier, Thomas; Joost, Alexander; Kazemi, Ahmad; Fuernau, Georg; Saraei, Roza; Kuck, Karl‐Heinz; Eitel, Ingo; Tilz, Roland Richard

doi:10.1002/ehf2.13698

Cited by 11 publications

(7 citation statements)

References 31 publications

(54 reference statements)

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“…Therefore, the 2016 ESC guidelines recommend: for patients with atrial fibrillation at high stroke risk, even after Catheter ablation also requires long-term oral anticoagulation to prevent stroke. The safety and efficacy of LAAC have been confirmed by a number of clinical trials (Cruz-González et al, 2020;Glikson et al, 2020;Mohrez et al, 2021;Saad et al, 2022), LAAC is no less effective than warfarin in preventing thromboembolic events, and the long-term bleeding risk is much lower than warfarin. Left atrial appendage closure (LAAC) is an alternative treatment strategy for stroke prevention in patients with atrial fibrillation who are not candidates for long-term oral anticoagulant therapy (Cruz-González et al, 2020;Takeda et al, 2022).…”

Section: Discussionmentioning

confidence: 96%

Effects of different interventions on prognosis and quality of life in patients with atrial fibrillation

Wang

Huang

et al. 2022

Noninvasive Electrocardiol

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Objective To compare the effects of different intervention measures on prognosis and quality of life in patients with atrial fibrillation, in order to provide clinical basis for diagnosis and treatment. Methods A total of 160 patients who visited several hospitals including Shanghai Xinhua Hospital from June 2019 to June 2021 were selected. Among them, 40 cases were in the drug treatment group (DRUG group), 40 cases in the radiofrequency ablation group (Radiofrequency ablation, RFA group), and 40 cases in the catheter ablation combined with percutaneous left atrial appendage occlusion group (“"one‐stop”" procedure group) and 40 cases in the percutaneous left atrial appendage closure group (Left atrial appendage closure, LAAC group). The Minnesota quality of life score (MLHFQ), ejection fraction (LVEF), and left atrial anterior and posterior diameters (LAD) were compared between the groups at 1‐year follow‐up, and the differences in adverse events were compared between the groups. Results (1) After a 1‐year follow‐up, overall comparison, the MLHFQ scores and the LVEF and the LAD among the four groups were statistically different (p < .01); (2) Multiple comparisons, ① the MLHFQ scores: The RFA group was the lowest, the “one‐stop” operation group was lower than the DRUG group, the LAAC group was the highest (p < .01). ② LVEF: The RFA group was the highest, the “one‐stop” procedure group was higher than the drug treatment group, the LAAC group was the lowest (p < .01). ③ LAD: the RFA group and the “one‐stop” procedure group were smaller than the DRUG group, the DRUG group was smaller than the LAAC group (p < .01).(3) Compared with the baseline data after 1‐year follow‐up in each group, in the RFA group and in the “one‐stop” procedure group, the MLHFQ scores was decreased, the LVEF was increased, and the LAD was decreased (p < .01); in the DRUG group: the difference was not statistically significant (p > .05); in the LAAC group, the MLHFQ scores was increased, the LVEF was decreased, and the LAD was increased (p < .01). (4) There were significant differences in the incidence of adverse events among the four groups (p < .01), the lowest in the RFA group and the highest in the LAAC group. Conclusion Compared with drug treatment, radiofrequency ablation and “one‐stop” procedure group can improve the quality of life of patients with atrial fibrillation, improve cardiac function, and reduce the occurrence of adverse events. Percutaneous left atrial appendage occlusion affects patients' quality of life and improves cardiac function, and increases the incidence of adverse events.

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Section: Discussionmentioning

confidence: 96%

Effects of different interventions on prognosis and quality of life in patients with atrial fibrillation

Wang

Huang

et al. 2022

Noninvasive Electrocardiol

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“…121 Another study observed during a 3-year follow-up a higher rate of major adverse cardiac and cerebrovascular events (31% vs. 15%) and of death (24% vs. 7%). 122 The impaired outcome was, however, attributed by the authors to the overall adverse outcome due to the HF comorbidity compared to the non-HF group.…”

Section: Anticoagulation For Stroke Prevention In Heart Failurementioning

confidence: 89%

“…However, higher incidence of non‐cardiac complications such as acute kidney injury and respiratory failure were noted for the HF subgroup 121 . Another study observed during a 3‐year follow‐up a higher rate of major adverse cardiac and cerebrovascular events (31% vs. 15%) and of death (24% vs. 7%) 122 . The impaired outcome was, however, attributed by the authors to the overall adverse outcome due to the HF comorbidity compared to the non‐HF group.…”

Section: Anticoagulation For Stroke Prevention In Heart Failurementioning

confidence: 97%

Interaction of heart failure and stroke: A clinical consensus statement of the ESC Council on Stroke, the Heart Failure Association (HFA) and the ESC Working Group on Thrombosis

Doehner,

Böhm,

Boriani

et al. 2023

European J of Heart Fail

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Heart failure (HF) is a major disease in our society that often presents with multiple comorbidities with mutual interaction and aggravation. The comorbidity of HF and stroke is a high risk condition that requires particular attention to ensure early detection of complications, efficient diagnostic workup, close monitoring, and consequent treatment of the patient. The bi‐directional interaction between the heart and the brain is inherent in the pathophysiology of HF where HF may be causal for acute cerebral injury, and ‐ in turn ‐ acute cerebral injury via imbalanced neural and neurovegetative control of cardiovascular regulation may induce or aggravate HF.The present document represents the consensus view of the ESC Council on Stroke, the Heart Failure Association and the ESC Working Group on Thrombosis to summarize current insights on pathophysiologic interactions of the heart and the brain in the comorbidity of HF and stroke. Principal aspects of diagnostic workup, pathophysiologic mechanisms, complications clinical management in acute conditions and in long‐term care of patients with the comorbidity are presented and state of the art clinical management and current evidence from clinical trials is discussed. Beside the physicians perspective, also the patients values and preferences are taken into account.Interdisciplinary cooperation of cardiologists, stroke specialists, other specialists and primary care physicians is pivotal to ensure optimal treatment in acute events and in continued long‐term treatment of these patients. Key consensus statements are presented in a concise overview on mechanistic insights, diagnostic workup, prevention and treatment to inform clinical acute and continued care of patients with the comorbidity of heart failure and stroke.

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“…In addition, several blood biomarkers have been shown to be associated with the presence of LAA thrombosis. Brain natriuretic peptide (BNP), mean erythrocyte volume, mean platelet volume, and eosinophil count have additional diagnostic effects above CHADS 2 (16,17). Clinical risk factors included hypertension, congestive heart failure, age, female, structural heart disease or cardiomyopathy, use of antiarrhythmic drugs, persistent and paroxysmal atrial fibrillation, and higher CHADS 2 score (18,19).…”

Section: Discussionmentioning

confidence: 99%

Prediction model based on machine learning for short- and long-term adverse events in left atrial appendage closure

Zhang¹,

Tian²,

Cong³

et al. 2022

J Thorac Dis

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Atrial appendage closure in patients with heart failure and atrial fibrillation: industry‐independent single‐centre study

Cited by 11 publications

References 31 publications

Effects of different interventions on prognosis and quality of life in patients with atrial fibrillation

Effects of different interventions on prognosis and quality of life in patients with atrial fibrillation

Interaction of heart failure and stroke: A clinical consensus statement of the ESC Council on Stroke, the Heart Failure Association (HFA) and the ESC Working Group on Thrombosis

Prediction model based on machine learning for short- and long-term adverse events in left atrial appendage closure

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