Left atrial appendage occlusion with Amplatzer Cardio Plug is an acceptable therapeutic option for prevention of stroke recurrence in patients with non-valvular atrial fibrillation and contraindication or failure of oral anticoagulation with acenocumarol

Arq Neuropsiquiatr. 2016 Mar;74(3):219-22. doi: 10.1590/0004-282X20150210.

Abstract

Left atrial appendage occlusion (LAAO) appears as a therapeutic option for some atrial fibrillation patients not suitable for oral anticoagulation because an increased hemorrhagic risk or recurrent ischemic events despite anticoagulant treatment.

Methods: Report of consecutive atrial fibrillation patients treated with LAAO with Amplatzer Cardio Plug because contraindication or failure of oral anticoagulation with acenocumarol. CHA2DS2VASC, HAS-BLED, NIHSS, mRS, procedural complications and outcome were assessed. Seven patients (73 ± 6 year-old) were treated after intracerebral (n = 5) and gastrointestinal (n = 1) hemorrhages or ischemic stroke recurrence while on acenocumarol (n = 1).

Results: Mean follow up was 18 months. Baseline CHA2DS2Vasc y HAS-BLED scores were 5.6 ± 0.7 and 4.1 ± 0.3 respectively. There were no strokes or deaths. There was only one non-serious adverse event.

Conclusion: LAAO with ACP appears as a feasible therapeutic option for stroke prevention in patients with atrial fibrillation and failure or contraindication to acenocumarol.

MeSH terms

  • Acenocoumarol*
  • Aged
  • Aged, 80 and over
  • Anticoagulants*
  • Atrial Appendage*
  • Balloon Occlusion / methods*
  • Contraindications
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Recurrence
  • Secondary Prevention
  • Stroke / therapy*
  • Treatment Outcome

Substances

  • Anticoagulants
  • Acenocoumarol