Impact of chronic kidney disease on left atrial appendage occlusion for stroke prevention in patients with atrial fibrillation

Abstract Background Left atrial appendage occlusion (LAAO) using the Amplatzer cardiac plug (ACP) is a preventive treatment of atrial fibrillation related thromboembolism. Aim To assess the safety and efficacy of LAAO in patients with chronic kidney disease (CKD). Methods Among the ACP multicentre registry, 1014 patients (75±8yrs) with available renal function were included. Results Patients with CKD (N=375, CHA2DS2-VASc: 4.9±1.5, HASBLED: 3.4±1.3) were at higher risk than patients without CKD (N=639, CHA2DS2-VASc: 4.2±1.6, HASBLED: 2.9±1.2; p 2 . Conclusion LAAO using the ACP has a similar procedural safety among CKD patients compared to patients with normal renal function. LAAO with ACP offers a dramatic reduction of stroke+TIA rate and of bleeding rate persistent in all stages of CKD, as compared to the expected annual risk.