Study on the safety and efficacy of minimally invasive left atrial appendage closure combined with catheter ablation in one-stop treatment of non-valvular atrial fibrillation

Chen Haoran; He Yuan

doi:10.3760/j.issn.1673-4777.2025.05.003

Abstract：Objective To investigate the safety and efficacy of minimally invasive left atrial appendage closure(LAAC)combined with catheter ablation(CA)in one-stop treatment of non-valvular atrial fibrillation(NVAF).Methods From August 2022 to July 2023,patients with NVAF who underwent one-stop minimally invasive LAAC combined with CA(one-stop group,20 cases)and only CA(single ablation group,22 cases)in the Department of Cardiology,Maoming People's Hospital,Guangdong Province were retrospectively analyzed.The baseline data,surgical procedures,perioperative complications,postoperative medications and 12-month follow-up results were collected and analyzed.Results The proportion of ischemic stroke history,CHA2DS2-VASc score,HAS-BLED score,left atrial anteroposterior diameter in the one-stop group were higher than those in the single ablation group(all P＜0.05).In terms of perioperative complications,there was 1 case of pseudoaneurysm vascular complication and 2 cases of epistaxis in the one-stop group,and no pericardial effusion and stroke events occurred in the two groups.There was significant difference in the oral administration of single drug between the two groups(P=0.038).In the one-stop group,there were 3 cases of recurrent atrial fibrillation,1 case of bleeding event,and no stroke.There were no recurrent atrial fibrillation,bleeding events and stroke in the single ablation group.Three patients had a residual shunt less than 3 mm at 3 months after surgery,and no patient had a residual shunt greater than 5 mm.Conclusions Minimally invasive LAAC combined with CA one-stop procedure is suitable for patients with high risk of thromboembolism and bleeding.One-stop procedure simplifies the procedure,reduces the risk,does not rely on transesophageal echocardiography,improves operability and safety,and is equivalent to simple CA surgery,and may be more effective in high-risk patients.