Percutaneous left atrial appendage closure (LAAC) is accepted as a valuable solution for patients (pts) with atrial fibrillation (AF) and high thromboembolic risk in case of contra-indication to oral anticoagulation (OAC). Little is known about mid-term results in the real life setting.

We analyzed mid-term results in a dedicated EP team (2 experienced electrophysiologists [AF ablation>200 per yr], 1 echographist, 1 anesthesiologist). All indications were discussed before the procedure in a multidisciplinary approach.

Procedures were done under general anesthesia in a dedicated EP room with in-hospital cardiac surgery facilities. All LAAC procedures were performed with Watchman devices (Boston Scientific).

50 pts were enrolled (male 76%, 77±6 years, paroxysmal AF 44%, permanent 54%). The CHADS2 VASC average score was 4.6±1,3;≥4: 76%, HASBLED score was 3,7±1:≥4: 64%. All indications were definitive contra-indications for OAC due to hemorrhagic events (neurological 75%, gastrointestinal 13%, ENT 3%, other 4%). The CT-scan ruled out any thrombus before the procedure for all pts with a perioperative TEE confirmation. Success rate of implantation was 100% (time of procedure 50±10min, scopy time 8±3mn). There were no periprocedure complications.

Postoperative therapy was: antiagregation 31%, double antiagregation 37%, anticoagulation 18%, none 3%. After 2 months, and TEE control, the initial treatment was switched to: antiagregation 50%, double antiagregation 10%, anticoagulation 10%, none 30%. Mid-term complications were: non severe pulmonary embolism N=1, recurrent non severe hemorrhagic stroke N=1, TIA due to carotid stenosis N=1. There were no other adverse events during 7,4±5 months follow-up.

In a single center with large experience in EP, LAAC was performed with a very low rate of complications and excellent mid-term results regarding recurrences of thromboembolic and hemorrhagic events.