Comparison of Outcomes of Left Atrial Appendage Occlusion (WATCHMAN Device) in Age < 80 versus Age >/= 80
Presenter
Shilla Zachariah, DO, Tower Health - Reading Hospital, Reading, PA
Shilla Zachariah, DO1, Keerat Rai R Ahuja, M.D.2, Salik Nazir, M.D.3, Satish Ahuja, MD4, Charnjeet Singh Sandhu, MD5, Muhammad Ameen, MD6, Rishin Handa, MD6, Murtaza Sundhu, MD6, Ore Oladiran, MD7 and Michael Macciocca, M.D.6, (1)Tower Health - Reading Hospital, Reading, PA, (2)Deborah Heart and Lung Center, Browns Mills, NJ, (3)-, Toledo, OH, (4)Jinnah Sindh Medical University, Karachi, Pakistan, (5)Kaiser Permanente Los Angeles Medical Center, Arcadia, CA, (6)Reading Hospital, Reading, PA, (7)Reading Hospital/Tower Health, Wyomissing, PA
Keywords: Embolic Protection, Left Atrial Appendage Closure (LAAC) and Occlusion Devices
Background
Percutaneous left atrial appendage occlusion (LAAO) is utilized as an alternative to oral anticoagulation in patients with atrial fibrillation not suitable for anticoagulation. We sought to study outcomes of LAAO in highly aged patients (>/=80 year).
Methods
Data from Nationwide readmission Database from January 2016 to December 2018 was queried for adult patients undergoing LAAO. Hierarchical multivariate logistic regression analysis was done to compare outcomes between two groups (age <80 vs. >/=80 [highly aged]).
Results
Of 19,728 total LAAO procedures, 6,040 (30%) were performed in highly aged patients (mean age 83.90 ± 2.9). Baseline characteristics comparing two groups are mentioned in Table 1. On multivariate analysis, there was no statistically significant difference in in-hospital mortality, (0.3% vs 0.5% p-value = 0.87), stroke or transient ischemic attack (TIA) (1.6% vs 1.2% p-value= 0.31), bleeding/transfusion (p-value = 4.1% vs 6.1% p-value = 0.15), vascular complications (0.3% vs 0.4% p-value = 0.89) and systemic embolization (0.2% vs 0.2% p-value = 0.84) between highly aged vs patients <80 years. (Table 1)
Conclusions
LAAO using a watchman device is safe in elderly patients. Future studies are warranted to study the long-term outcomes of LAAO in highly aged patients.
