The success rate of left atrial appendage closure to prevent stroke was high and the rate of complications was low in patients with cardiac amyloidosis, according to a new study published in the Journal of Cardiovascular Electrophysiology.
The procedure can therefore be regarded as safe and feasible in these patients.
To assess the safety, procedural success, and clinical outcomes of the approach in patients with cardiac amyloidosis, a team of researchers, led by Mazen Hanna, MD, from the Cleveland Clinic in Ohio, retrospectively analyzed 21 patients with confirmed cardiac amyloidosis who had undergone left atrial appendage closure between January 2014 and December 2024.
The researchers collected data about patient demographics, the details of the procedure, patient management following the procedure, and patient outcomes.
The majority of the patients (90.5%) had wild-type transthyretin-mediated amyloid cardiomyopathy (ATTR-CM), and 71.4% had persistent atrial fibrillation.
The results showed that procedural success was achieved in 95% of patients without any complications occurring before, during, or after the procedure.
Over a median follow-up of 2 years, there were also no cases of device-related thrombosis or major peri-device leaks.
A total of 3 patients (14.3%) had minor peri-device leak, and 2 patients (9.5%) had major bleeding. This occurred while on postprocedural oral anticoagulation. Additionally, 2 patients had ischemic stroke or transient ischemic attack, and both patients were given direct oral anticoagulation as a result.
“Further prospective studies are needed to determine the long‐term safety of this procedure in this unique patient group,” the researchers said.
Cardiac amyloidosis is a type of progressive, infiltrative cardiomyopathy that results in a high risk of thromboembolic events, especially in the setting of atrial fibrillation. ATTR-CM is caused by the accumulation of misfolded TTR protein fragments in the myocardium.
This article originally appeared on Rare Disease Advisor