• Cardiol J · Jan 2017

    Twelve-month follow-up of left atrial appendage occlusion with Amplatzer Amulet.

    • Caroline Kleinecke, Jai-Wun Park, Martin Gödde, Konstantin Zintl, Steffen Schnupp, and Johannes Brachmann.
    • Medical Clinic II (Cardiology/Intensive Care Medicine), Ketschendorfer Straße 33, 96450 Coburg, Germany, Tel. +49 9561 22 33215, Fax +49 9561 226419. carolinekleinecke@web.de.
    • Cardiol J. 2017 Jan 1; 24 (2): 131-138.

    BackgroundThe Amplatzer Amulet (St. Jude Medical, Minneapolis, MN, USA) is a second gen-eration Amplatzer device for left atrial appendage (LAA) occlusion (LAAO) for stroke prophylaxis in patients with atrial fibrillation. This research sought to assess the clinical performance of the Amplatzer Amulet device and in follow up for 12 months.MethodsIn this single-center registry patients with atrial fibrillation and contraindication to oral anticoagulation underwent LAAO with the Amplatzer Amulet device. Follow-up was performed before discharge, by transesophageal echocardiography (TEE) after 6 weeks and telephone interview after 3, 6 and 12 months.ResultsBetween October 2014 and August 2015 50 patients (76.1 ± 8.3 years; 30 male) were en-rolled. Procedural success was achieved in 49 (98%) patients. Major periprocedural adverse events were observed in 4 (8%) of patients: 1 device embolization, 2 pericardial effusions requiring pericardiocente-sis and 1 prolonged hospital stay due to retropharyngeal hematoma from the TEE probe. Follow-up TEE was available in 38 of 50 patients showing complete LAA sealing in all. 2 device-related thrombi were also documented. At 12-month follow-up 7 patients had died unrelated to the device. Ischemic stroke occurred in 3 patients. According to neurological examination two were classified as microangiopathic and not cardio-embolic. The other one could not be classified. Bleeding complications (5 minor, 3 major) were documented in 8 patients.ConclusionsAlthough minimizing procedure-related complications remains challenging, LAAO with the Amplatzer Amulet device showed high procedural success and excellent LAA sealing. (Cardiol J 2017; 24, 2: 131-138).

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