Left atrial appendage closure (LAAC) may provide value as a “safe and feasible” treatment option for preventing stroke in patients with hypertrophic cardiomyopathy (HCM) and atrial fibrillation (AFib), according to a new pilot study out of China.
The analysis, published in Frontiers in Cardiovascular Medicine, included 36 patients who underwent LAAC from April 2017 to December 2019 at a single facility.
“Currently, LAAC is recommend as an alternative to anticoagulation therapy for stroke prevention in the general AFib population with high risk of stroke,” wrote first author Bin-Feng Mo, a cardiologist at Xinhua Hospital in China, and colleagues. “However, the efficacy of LAAC for stroke prevention in the specific population of HCM and AFib is unknown.”
Each LAAC procedure was performed using a Watchman device from Boston Scientific. While 22 procedures were for primary stroke prevention, the other 14 were performed with secondary stroke prevention in mind. All patients presented with both HCM and AFib.
Each patient underwent transesophageal echocardiography prior to the LAAC to rule out left atrial appendage thrombi. Follow-up appointments were scheduled after three, six and 12 months—and once every six months after that.
Overall, the team reported, a successful closure was confirmed in all patients. Also, there were no thromboembolic events or deaths in the entire patient population. One device-related thrombus was identified and “resolved after anticoagulation.”
After a mean follow-up period of more than two years, one bleeding event had been reported.
“Our data suggest that LAAC operations seem to be feasible and safe for stroke prevention in this special population,” the authors concluded. “Further studies with larger samples are required.”
The full study can be read here.
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