title: Transcatheter left atrial appendage closure for stroke prevention in atrial fibrillation with Amplatzer cardiac plug: the Belgian Registry.
abstract: OBJECTIVE
  The aim of the present study was to evaluate the procedural feasibility, the safety and the 1-year outcome following left atrial appendage (LAA) closure using the Amplatzer cardiac plug (ACP) in Belgium.
  
  
  RESULTS
  Data were prospectively collected among 90 consecutive patients, undergoing LAA closure with an ACP in 7 Belgian centres between June 2009 and September 2012. The patients (56 males, 74 +/- 8 years) were at high risk for stroke (CHA2DS2-VASc = 4.4 +/- 1.8) and bleeding (HAS-BLED = 3.3 +/- 1.3).Technical success was obtained in all but one patient and procedural success was 95%. Procedural major adverse events (MAE) were 3 tamponades resulting in death in one case. Minor complications were 3 insignificant pericardial effusions, 2 transient myocardial ischaemia due to air embolism and 1 femoral pseudoaneurysm. At 1-y follow-up, there were 4 deaths, 2 minor strokes, 1 tamponade and 1 myocardial infarction. Overall survival was 94% and freedom from MAE was 88%. In our population, the expected annual stroke risk according to the CHA2DS2-VASc score was 5.08%, while the observed stroke rate was 2.14%/year.
  
  
  CONCLUSIONS
  The Belgian registry shows that LAA closure using the ACP device is feasible and safe. At 1-y follow-up, the observed stroke rate was 2.14%/year, less than predicted by the CHA2DS2-VASc score. Longer follow-up is needed to evaluate the long-term safety and its efficacy in reducing stroke.
authors.affiliation: Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium. joelle.kefer@uclouvain.be
authors.forename: Joëlle
authors.initials: J
authors.lastname: Kefer
authors.affiliation: Middelheim ZNA, Antwerpen, Belgium.
authors.forename: Paul
authors.initials: P
authors.lastname: Vermeersch
authors.affiliation: UZ Leuven, Leuven, Belgium.
authors.forename: Werner
authors.initials: W
authors.lastname: Budts
authors.affiliation: OLV Ziekenhuis Aalst, Belgium.
authors.forename: Tom
authors.initials: T
authors.lastname: Depotter
authors.affiliation: CHU Charleroi, Charleroi, Belgium.
authors.forename: Adel
authors.initials: A
authors.lastname: Aminian
authors.affiliation: Jessaziekenhuis, Hasselt, Belgium.
authors.forename: Edouard
authors.initials: E
authors.lastname: Benit
authors.affiliation: Heilig Hart Roeselare, Roeselare, Belgium.
authors.forename: Francis
authors.initials: F
authors.lastname: Stammen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020517:Atrial Appendage / Q000000981:diagnostic imaging / Q000601:surgery*; D001281:Atrial Fibrillation / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D001530:Belgium / Q000453:epidemiology; D006328:Cardiac Catheterization / Q000379:methods*; D006348:Cardiac Surgical Procedures / Q000295:instrumentation*; D002932:Cineangiography; D017548:Echocardiography, Transesophageal; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries; D055989:Septal Occluder Device; D020521:Stroke / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome