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Twelve-month follow-up of left atrial appendage occlusion with Amplatzer Amulet.

Twelve-month follow-up of left atrial appendage occlusion with Amplatzer Amulet.
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Kleinecke C, Park JW, Gödde M, Zintl K, Schnupp S, Brachmann J,


Kleinecke C, Park JW, Gödde M, Zintl K, Schnupp S, Brachmann J, (click to view)

Kleinecke C, Park JW, Gödde M, Zintl K, Schnupp S, Brachmann J,

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Cardiology journal 2017 02 15() doi 10.5603/CJ.a2017.0017
Abstract
BACKGROUND
The Amplatzer Amulet (St. Jude Medical, Minneapolis, MN, USA) is a second generation Amplatzer device for left atrial appendage occlusion for stroke prophylaxis in patients with atrial fibrillation. This research sought to assess the clinical performance of the Amplatzer Amulet device and in follow up for 12 months.

METHODS
In this single-center registry patients with atrial fibrillation and contraindication to oral anticoagulation underwent left atrial appendage occlusion (LAAO) with the Amplatzer Amulet device. Follow-up was performed before discharge, by transesophageal echocardiography (TEE) after 6 weeks and telephone interview after 3, 6 and 12 months.

RESULTS
Between October 2014 and August 2015 50 patients (76.1 ± 8.3 years; 30 male) were enrolled. Procedural success was achieved in 49 (98%) patients. Major periprocedural adverse events were observed in 4 (8%) of patients: 1 device embolization, 2 pericardial effusions requiring pericardiocentesis and 1 prolonged hospital stay due to retropharyngeal hematoma from the TEE probe. Follow-up TEE was available in 38 of 50 patients showing complete left atrial appendage (LAA) sealing in all. 2 device-related thrombi were also documented. At 12-month follow-up 7 patients had died unrelated to the device. Ischemic stroke occurred in 3 patients. According to neurological examination two were classified as microangiopathic and not cardio-embolic. The other one could not be classified. Bleeding complications (5 minor, 3 major) were documented in 8 patients.

CONCLUSIONS
Although minimizing procedure-related complications remains challenging, LAAO with the Amplatzer Amulet device showed high procedural success and excellent LAA sealing.

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