Reduction in risk of stroke and bleeding after left atrial appendage closure with LARIAT device in patients with increased risk of stroke and bleeding: Long term results.

Background: Left atrial appendage occlusion (LAAO) offers an alternative to oral anticoagulation (OAC) for patients with atrial fibrillation (AF). The aim of this study was to present long-term clinical outcomes of LAAO in patients with a high risk of stroke and thromboembolic events (CHA2 DS2 -VAS-score ≥ 2) and bleeding (HAS-BLED score ≥ 2).

Methods: A prospective, single-center study was performed in 120 patients who were screened for LAAO with the LARIAT. Out of these 89 patients were underwent LARIAT placement, were 57 had high risk of thromboembolic and bleeding risk (LAA group). Control Group consisted of patients and 31 who screened out from the LARIAT and did not undergo LAAO.

Results: The mean CHA2 DS2 -VAS-score was 3.6 ± 1.5 versus 3.1 ± 1.2 and HAS-BLED score was 3.6 ± 1 versus 3 ± 1 compare LAA group versus control group. There were no thromboembolic events in the LAA group. In the control group thromboembolic events were observed in 9.6% (P = 0.017). Annual mortality rate was 1.8% in LAA group and 3.2% in control group (P < 0.05). Estimated bleeding risk reduction in LAA group was 62.2%.

Conclusions: Long-term data confirmed that left atrial appendage closure with the LARIAT device is an effective and safe treatment in nonvalvular AF patients with high risk of stroke and bleeding.