Division of Cardiology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou 310015, P. R. China.
School of Medicine, Hangzhou Normal University, Hangzhou 311121, P. R. China.
Rev Cardiovasc Med. 2020 Sep 30;21(3):443-451. doi: 10.31083/j.rcm.2020.03.62.
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.
心房颤动（AF）是老年人中最常见的心律失常，在慢性肾脏病（CKD）患者中更为常见。左心耳封堵术（LAAO）作为一种机械替代方法，用于预防与 AF 相关的血栓栓塞。本荟萃分析旨在为 LAAO 在伴有 CKD 的 AF 患者中的临床应用提供建议。通过单率荟萃分析评估围手术期不良事件和其他临床效果的发生率。结果表明，LAAO 术后围手术期不良事件的发生率一般较低，仅有心包积液/填塞（1.90%）和死亡率（1.10%）。在随访期间，卒中/短暂性脑缺血发作（TIA）和出血的发生率分别为 2.17%和 4.53%。LAAO 术后围手术期不良事件发生率较低。这些结果表明，与口服抗凝剂相比，LAAO 更有效地预防卒中/TIA 的发生，并最大限度地减少出血事件。
