IMR Press / RCM / Volume 21 / Issue 3 / DOI: 10.31083/j.rcm.2020.03.62
Open Access Systematic Review
Efficacy and safety of left atrial appendage occlusion in atrial fibrillation patients with chronic kidney disease: a systematic review and meta-analysis
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1 Division of Cardiology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou 310015, P. R. China
2 School of Medicine, Hangzhou Normal University, Hangzhou 311121, P. R. China

These authors contributed equally.

Rev. Cardiovasc. Med. 2020 , 21(3), 443–451; https://doi.org/10.31083/j.rcm.2020.03.62
Submitted: 15 April 2020 | Revised: 24 July 2020 | Accepted: 27 July 2020 | Published: 30 September 2020
Abstract

Atrial fibrillation (AF) is the most common arrhythmia among the elderly, and more frequently occur in those with chronic kidney disease (CKD). Left atrial appendage occlusion (LAAO) is used as a mechanical alternative approach for prevention of AF-related thromboembolisms. This meta-analysis was conducted to provide suggestions for the clinical application of LAAO in AF patients with CKD. The incidence of perioperative adverse events and other clinical effects after operation was by a single rate meta-analysis. Results showed that incidence of adverse events in the perioperative period after LAAO was generally low, with only pericardial effusion / tamponade (1.90%) and mortality rate (1.10%). During the follow-up period, the incidence of stroke/transient ischemic attack (TIA) and bleeding were 2.17% and 4.53%, respectively. A low incidence rate of adverse events was found in the perioperative period following LAAO. These results indicate that LAAO more effectively prevents the occurrence of stroke/TIA and minimizes bleeding events than oral anticoagulants.

Keywords
Atrial fibrillation
chronic kidney disease
left atrial appendage occlusion
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