An EP wire survey was performed to assess the indications and anticoagulation strategies post left atrial appendage occluder (LAAO) implantation for stroke prevention in patients with non-valvular atrial fibrillation in Europe. We compared different approaches between German and other European hospitals.

Methods and Results

Total of 24 centers in 13 European countries completed the questionnaire. Among them were seven German centers. All centers were members of the EHRA Research Network. Patients with absolute contraindication to novel/oral anticoagulation therapy (N/OAC) were deemed to be candidates for LAAO in all European as well as in German centers. All German centers but only 20% of the European centers (6 of 24) consider LAAO in patients with a history of bleeding on N/OAC, as an indication for LAAO.

‘’High Costs’’ are predominant reasons for not implanting LAAO in 18% of the European centers, whereas that doest limit the implantation of LAAO in German centers.

Following LAA occlusion, 8 of 24 (34%) European centers and 5 of 7 German centers prescribed dual antiplatelet therapy (DAT) for a limited period (e.g. up to 6 weeks - 6 months), followed by antiplatelet therapy. Only two German centers (18%) prescribed OAC for 6 weeks and DAT for 6 months.

Conclusion:

This analysis highlights differences in the management of LAAO between European and German centers.