Effect of chronic kidney disease on the efficacy of left atrial appendage closure in patients with atrial fibrillation
XIAO Hong
SHEN Jing-jing
LI wei
LI Yi-lan
WANG An-ning
Abstract：Objective To investigating the safety and efficacy of left atrial appendage closure in patients with atrial fibrillation combined with chronic kidney disease(CKD).Methods A total of 119 patients with atrial fibrillation who met the inclusion criteria for left atrial appendage closure in The Affiliated Hospital of Guizhou Medical University from September 1,2022 to July 31,2023 were retrospectively selected,including 34 in the CKD group and 85 in the non-CKD group;the clinical baseline data,preoperative laboratory and ultrasound indicators,and perioperative complications were compared between the two groups;and the postoperative device-related thrombosis,left atrial appendage residual shunt,pericardial effusion and thromboembolism,hemorrhage and all-cause mortality were followed up.Results The age,alcohol consumption,smoking,heart failure and coronary heart disease ratio,CHA2DS2-VASc score and HAS-BLED score in the CKD group were higher than those in the non-CKD group,all of which were statistically different(all P<0.05).Only one patient in the CKD group failed to be implanted with an occluder due to left atrial appendage malformation,and the success rate of implantation was 97.1%;the success rate of implantation in the non-CKD group was 100%;and there was no statistical difference in pericardial effusion between the two groups(P>0.05).After 6 months of follow-up,there were no statistically significant differences in device-related thrombosis,left atrial appendage residual shunt,and pericardial effusion between the two groups(P>0.05).After 17 months of follow-up,there was no statistically significant difference in the incidence of thromboembolism,hemorrhage and all-cause death between the two groups(P>0.05).Conclusion Patients with atrial fibrillation with CKD tend to be older,have more comorbidities and have a higher risk of stroke and bleeding,but the success rate of implantation is still high when undergoing left atrial appendage closure;and compared with non-CKD patients,CKD does not increase the risk of thromboembolism,bleeding and all-cause death after the surgery,and has a higher safety.
Keywords：Atrial fibrillationChronic kidney diseaseLeft auricular occlusionImpact of efficacy
Publication Date：2025-01-09
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 3-8 )