Investigating Left Atrial Appendage Closure in Patients with Atrial Fibrillation

According to Mostafa Reda Mostafa and collaborating researchers, left atrial (LA) appendage closure (AC) showed an association with improvement in left atrial emptying fraction—but no other parameters—in patients with atrial fibrillation who were not eligible for long-term anticoagulation. The study was published in Clinical Cardiology.

The final meta-analysis included 260 patients from a total of eight studies on the effect of LAAC on LA function. The authors’ report presented standardized mean differences (SMD) based on the collated means and standard deviations.

After LAAC, the authors reported that there was a significant increase in LA emptying fraction compared to pre-LAAC measures (SMD: 0.53; 95% CI, 0.04-1.01; p = 0.03; I2 = 75%). Conversely, the authors noted that there were no significant changes in LA volume (SMD: -0.07; 95% CI: -0.82 to 0.69; p = 0.86; I2 = 92%), peak atrial longitudinal strain (SMD: 0.50; 95% CI: -0.08 to 1.08; p = 0.09; I2 = 89%), peak atrial contraction strain (SMD: 0.38; 95% CI: -0.22 to 0.99; p = 0.21; I2 = 81%), strain during atrial contraction (SMD: -0.24; 95% CI: -0.61 to 0.13; p = 0.20; I2 = 0%), strain during ventricular systole (SMD: 0.47; 95% CI: -0.32 to 1.27; p = 0.24; I2 = 89%), or strain during ventricular diastole (SMD: 0.09; 95% CI: -0.32 to 0.51; p = 0.66; I2 = 65%).

In closing, the authors suggested that “more research is warranted for better understanding of LA hemodynamics and its implications in clinical vignette.”