Introduction

Left atrial appendage closure has been introduced into clinical routine in Germany in 2009, especially in patients with contraindications to long-term anticoagulation therapy. Data from two randomized trials ( Protect AF , Prevail)  were able to show efficacy and safety of the therapy, however multicenter short term follow-up data in the real world setting are rare.

Methods

We combined data of prospective real world registries from five German high volume centers to analyze complication rate and short-term outcome of patients.

Results

We included data from 1591 consecutive patients, mean follow up 907 days (321 to 1640 days) from five German centers: Age: 73.8 ± 9.4 years; 606 women (38.1 %) and 985 men (61. 9 %); CHA₂DS₂VASC score:  4.2 ± 1.5; 847 (53.2%) > 75 years. Type of AF: 32.9% paroxysmal (524 patients), 36.8% permanent (586 patients), 24.9% persistent (396 patients), 5.3% unknown (85 patients). A Watchman device was implanted in 80.9% (1287 pts.), Amulet or ACP device was implanted in 65 patients and other devices (Coherex, Lambre, Occlutech, Watchman Flx) were implanted in the remaining pts.

The implantation procedure required 71.7 ml + 57.2 ml contrast medium and fluoroscopy time was 7.6+5.6 minutes. The overall periprocedural complication rate was 3.01% (48 out of 1591pts) with 1 death (0.1%), 3 stroke/TIA (0.2%), 28 pericardial effusions (1.8%), 4 device embolizations (0.3%) and 12 air embolism (0.8%).

Conclusion

In this short term analysis of real world data from 5 German high volume centers of LAA closure in patients with AF and contraindications for therapeutic anticoagulation, the periprocedural complication rate was lower than reported from the early experience of the Protect AF trial or the ACP registry. Our registry summarizes also the very early patients from the participating centers and the learning curve of the operators.