open access

Vol 24, No 2 (2017)
Original articles — Interventional cardiology
Published online: 2017-02-07
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Twelve-month follow-up of left atrial appendage occlusion with Amplatzer Amulet

Caroline Kleinecke, Jai-Wun Park, Martin Gödde, Konstantin Zintl, Steffen Schnupp, Johannes Brachmann
DOI: 10.5603/CJ.a2017.0017
·
Pubmed: 28198520
·
Cardiol J 2017;24(2):131-138.

open access

Vol 24, No 2 (2017)
Original articles — Interventional cardiology
Published online: 2017-02-07

Abstract

Background: The Amplatzer Amulet (St. Jude Medical, Minneapolis, MN, USA) is a second gen­eration Amplatzer device for left atrial appendage (LAA) occlusion (LAAO) 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 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 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. (Cardiol J 2017; 24, 2: 131–138)

Abstract

Background: The Amplatzer Amulet (St. Jude Medical, Minneapolis, MN, USA) is a second gen­eration Amplatzer device for left atrial appendage (LAA) occlusion (LAAO) 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 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 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. (Cardiol J 2017; 24, 2: 131–138)

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Keywords

left atrial appendage occlusion, Amplatzer Amulet, atrial fibrillation, stroke prophylaxis

About this article
Title

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

Journal

Cardiology Journal

Issue

Vol 24, No 2 (2017)

Pages

131-138

Published online

2017-02-07

DOI

10.5603/CJ.a2017.0017

Pubmed

28198520

Bibliographic record

Cardiol J 2017;24(2):131-138.

Keywords

left atrial appendage occlusion
Amplatzer Amulet
atrial fibrillation
stroke prophylaxis

Authors

Caroline Kleinecke
Jai-Wun Park
Martin Gödde
Konstantin Zintl
Steffen Schnupp
Johannes Brachmann

References (16)
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