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June 18, 2026Current Medical Research and Opinion

Concomitant heart failure during LAAC is linked to ~17% more periprocedural major adverse events.

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Why the study?

Does concomitant heart failure worsen periprocedural and long-term outcomes in patients with non-valvular atrial fibrillation undergoing percutaneous left atrial appendage closure?

Population

40 studies pooling 351,266 patients with non-valvular atrial fibrillation undergoing percutaneous left…

Comparison

Percutaneous left atrial appendage closure in… vs Percutaneous left atrial appendage closure in…

Design

Meta-analysis

Follow-up

long-term

Key result

Concomitant heart failure in patients undergoing left atrial appendage closure was associated with increased periprocedural major adverse events (OR 1.17; 95% CI 1.03-1.32).

Authors

MYMuhammad YusufCMClonia MillaLCLiani Amelia Chandra

Discussion

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Member takes

Overview

HF warrants heightened periprocedural vigilance and long-term monitoring in LAAC; extends observational evidence for risk stratification in NVAF.

Key Points

  • This research aims to evaluate the safety and efficacy of percutaneous left atrial appendage closure in patients with non-valvular atrial fibrillation and concomitant heart failure.
  • Conducted a systematic review and meta-analysis of studies from multiple databases.
  • Compared periprocedural and long-term outcomes of LAAC in patients with and without heart failure.
  • Used random-effects meta-analyses to calculate odds ratios and hazard ratios.
  • Patients with heart failure had higher odds for major adverse events (OR 1.17, 95% CI 1.03-1.32) and periprocedural mortality (OR 2.41, 95% CI 1.84-3.16).
  • Long-term follow-up indicated heart failure was associated with increased all-cause mortality (HR 1.83, 95% CI 1.50-2.22).
  • No significant differences were found in rates of long-term stroke, major bleeding, or peri-device leak between groups.

Study Design

Type

Meta-Analysis (n=351,266)

Structured PICO

Does concomitant heart failure worsen periprocedural and long-term outcomes in patients with non-valvular atrial fibrillation undergoing percutaneous left atrial appendage closure?

P
Population
351,266 patients with non-valvular atrial fibrillation undergoing percutaneous left atrial appendage closure, comparing those with and without heart failure.
E
Exposure
Percutaneous left atrial appendage closure (LAAC) in patients with concomitant heart failure
C
Comparator
Percutaneous left atrial appendage closure (LAAC) in patients without heart failure
O
Outcome
Periprocedural outcomes (major adverse events, mortality, major bleeding, stroke, pericardial effusion) and long-term outcomes (all-cause mortality, major adverse events, device-related thrombus, stroke, major bleeding, peri-device leak)hard clinical

Main Result

Odds Ratio: 1.17 (95% CI 1.03–1.32)

In patients with NVAF undergoing LAAC, concomitant heart failure is associated with higher periprocedural risk and worse long-term survival, though protection against thromboembolism remains comparable.

Cite This Study

Yusuf et al. (2026) conducted a meta-analysis in Non-valvular atrial fibrillation (n=351,266). Heart failure vs. Without heart failure was evaluated on Periprocedural major adverse events (OR 1.17, 95% CI 1.03-1.32). Concomitant heart failure in patients undergoing left atrial appendage closure was associated with increased periprocedural major adverse events (OR 1.17; 95% CI 1.03-1.32).

synapsesocial.com/papers/6a33cfcf14a9c556e6677923https://doi.org/10.1080/03007995.2026.2687640
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