Influence of gender on prognosis of atrial fibrillation patients after left atrial appendage occlusion

Abstract

Objective To explore the influence of gender on the prognosis of patients with atrial fibrillation (AF) undergoing left atrial appendage occlusion (LAAO). Methods All non-valvular AF patients who were admitted in our hospital and underwent LAAO from August 2014 to August 2021 were enrolled and grouped according to gender. Their general information, including gender, age, comorbid underlying diseases, and results of transthoracic echocardiography and transesophageal echocardiography (TEE) were collected. The incidences of device-related thrombosis (DRT), pericardial tamponade, stroke, bleeding, hospitalization for heart failure, and cardiac death were recorded during follow-up. The influence of gender on the prognosis of these patients was analyzed. Results There were totally 673 patients with non-valvular AF were enrolled, including 366 males and 307 females, at a mean age of 68.2±9.4 years. When compared with the male patients, the female ones had a higher CHA2DS2-VASc score (P < 0.01), but smaller proportions of history of stroke, average compression ratio of occluders, and incidence of residual shunt (< 3 mm) after occlusion (P < 0.05). In 45~60 d after surgery, TEE revealed that there were 17 cases of DRT, including 8 males (2.2%) and 9 females (2.9%), though without statistical difference between the groups. Among the 17 DRT cases, 1 experienced stroke, and the incidence of stroke was 5.9% in those with DRT and 0.5% without. There were 4 cases of postoperative pericardial tamponade, including 1 in the male group and 3 in the female group (no significant difference), and all of them were improved after pericardial puncture and fluid extraction. During the follow-up period of 40.2±20.5 months, no obvious differences were observed between the 2 groups in terms of stroke, bleeding, hospitalization for heart failure, and cardiogenic death. Conclusion Gender shows no significant effect on the prognosis of patients with non-valvular AF after LAAO.

Keywords

• atrial fibrillation
• left atrial appendage occlusion
• gender
• watchman
• stroke