Sammanfattning
BACKGROUND: Atrial fibrillation is common in the general population and increases the risk of stroke. Anticoagulant therapy is effective in preventing thromboembolism in cases of atrial fibrillation, but for various reasons many patients with atrial fibrillation with an indication for anticoagulant therapy do not receive it. Catheter-based left atrial appendage closure is a new method for preventing stroke in cases of atrial fibrillation.
MATERIAL AND METHOD: During the period September 2014–April 2016, 27 patients with atrial fibrillation and a high risk of stroke underwent attempted catheter-based left atrial appendage closure at Oslo University Hospital. Anticoagulant therapy was considered contraindicated in 26 of the patients. We present results from the procedure and echocardiography follow-up plus clinical events in the one-year follow-up period.
RESULTS: A left atrial appendage closure device (‘cardiac plug’) was successfully implanted in 26 patients. Two patients experienced complications in connection with the procedure: one had a stroke and the other required transfusion owing to a groin bleed. One patient developed cardiac tamponade five months after the procedure. One patient in whom a cardiac plug could not be implanted, owing to challenging anatomy, died in the follow-up period as a result of stroke. Three patients experienced a transient ischaemic attack (TIA). There were no cases of intracranial or gastrointestinal haemorrhage.
INTERPRETATION: Catheter-based left atrial appendage closure is feasible, but entails a risk of complications and should be reserved for patients at high risk of stroke and for whom anticoagulant therapy is contraindicated.