title: Left atrial appendage occlusion for stroke prevention in atrial fibrillation: multicentre experience with the AMPLATZER Cardiac Plug.
abstract: OBJECTIVE
  To investigate the safety, feasibility, and efficacy of left atrial appendage occlusion (LAAO) with the AMPLATZER Cardiac Plug (ACP) for stroke prevention in patients with atrial fibrillation (AF).
  
  
  RESULTS
  Data from consecutive patients treated in 22 centres were collected. A total of 1,047 patients were included in the study. Procedural success was 97.3%. There were 52 (4.97%) periprocedural major adverse events. Follow-up was complete in 1,001/1,019 (98.2%) of successfully implanted patients (average 13 months, total 1,349 patient-years). One-year all-cause mortality was 4.2%. No death at follow-up was reported as device-related. There were nine strokes (0.9%) and nine transient ischaemic attacks (0.9%) during follow-up. The annual rate of systemic thromboembolism was 2.3% (31/1,349 patient-years), which is a 59% risk reduction. There were 15 major bleedings (1.5%) during follow-up. The annual rate of major bleeding was 2.1% (28/1,349 patient-years), which is a 61% risk reduction. Patients with single LAAO on aspirin monotherapy or no therapy and longer follow-up had fewer cerebral and fewer bleeding events.
  
  
  CONCLUSIONS
  In this multicentre study, LAAO with the ACP showed high procedural success and a favourable outcome for the prevention of AF-related thromboembolism. Modification in antithrombotic therapy after LAAO may result in reduction of bleeding events.
authors.affiliation: AHEPA University Hospital, Thessaloniki, Greece.
authors.forename: Apostolos
authors.initials: A
authors.lastname: Tzikas
authors.forename: Samera
authors.initials: S
authors.lastname: Shakir
authors.forename: Sameer
authors.initials: S
authors.lastname: Gafoor
authors.forename: Heyder
authors.initials: H
authors.lastname: Omran
authors.forename: Sergio
authors.initials: S
authors.lastname: Berti
authors.forename: Gennaro
authors.initials: G
authors.lastname: Santoro
authors.forename: Joelle
authors.initials: J
authors.lastname: Kefer
authors.forename: Ulf
authors.initials: U
authors.lastname: Landmesser
authors.forename: Jens Erik
authors.initials: JE
authors.lastname: Nielsen-Kudsk
authors.forename: Ignacio
authors.initials: I
authors.lastname: Cruz-Gonzalez
authors.forename: Horst
authors.initials: H
authors.lastname: Sievert
authors.forename: Tobias
authors.initials: T
authors.lastname: Tichelbäcker
authors.forename: Prapa
authors.initials: P
authors.lastname: Kanagaratnam
authors.forename: Fabian
authors.initials: F
authors.lastname: Nietlispach
authors.forename: Adel
authors.initials: A
authors.lastname: Aminian
authors.forename: Friederike
authors.initials: F
authors.lastname: Kasch
authors.forename: Xavier
authors.initials: X
authors.lastname: Freixa
authors.forename: Paolo
authors.initials: P
authors.lastname: Danna
authors.forename: Marco
authors.initials: M
authors.lastname: Rezzaghi
authors.forename: Paul
authors.initials: P
authors.lastname: Vermeersch
authors.forename: Friederike
authors.initials: F
authors.lastname: Stock
authors.forename: Miroslava
authors.initials: M
authors.lastname: Stolcova
authors.forename: Marco
authors.initials: M
authors.lastname: Costa
authors.forename: Reda
authors.initials: R
authors.lastname: Ibrahim
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Schillinger
authors.forename: Bernhard
authors.initials: B
authors.lastname: Meier
authors.forename: Jai-Wun
authors.initials: JW
authors.lastname: Park
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use*; D020517:Atrial Appendage / Q000601:surgery*; D001281:Atrial Fibrillation / Q000628:therapy*; D006328:Cardiac Catheterization / Q000379:methods; D017548:Echocardiography, Transesophageal / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D055989:Septal Occluder Device / Q000009:adverse effects; D020521:Stroke / Q000517:prevention & control*; D013923:Thromboembolism / Q000209:etiology / Q000517:prevention & control; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants