A Current Perspective on Left Atrial Appendage Closure Device Infections: A Systematic Review.

IF 1.7 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Pace-Pacing and Clinical Electrophysiology Pub Date : 2025-03-28 DOI:10.1111/pace.15184

Yusuf Ziya Sener, Sumeyye Fatma Ozer, Gizem Karahan

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引用次数: 0

Abstract

Purpose: Left atrial appendage (LAA) closure has become the standard of care for patients with atrial fibrillation (AF) at high risk of thromboembolism who are intolerant or unwilling to take anticoagulants. LAA occlusion device infection is a challenging complication, and there is a paucity of data on the management and outcomes of LAA occlusion device infection. We aimed to summarize the existing literature and highlight the knowledge gap in this area.

Methods: A detailed search was conducted through the databases PubMed/MEDLINE, EMBASE, Web of Science, CINAHL, and Cochrane Central using the relevant keywords. All cases with presented data regarding diagnosis, treatment, and outcome were included from the reports.

Results: The analysis included 12 case reports encompassing a total of 12 patients. The mean age was 73.6 ± 11.0 years, and 50% of the cases were male. The most commonly implanted device was the Watchman (in eight of the 12 cases). The median time between LAA closure and infection was 6.6 (0.2-36) months. Transesophageal echocardiography was diagnostic in all cases, and positron emission tomography/computed tomography (PET/CT) was useful in diagnosis in three cases. The most common pathogen was Staphylococcus aureus (n = 7). The LAAC device was removed in seven cases; one patient refused surgery, and in the other three cases, removal of the device was not considered appropriate due to the patient's poor condition. Data on whether the device was removed could not be retrieved for one patient. Mortality occurred in three cases (25%), and all deaths occurred during hospitalization.

Conclusion: LAA closure device infections are rare but carry a high risk of complications and mortality. Treatment should include device removal in appropriate cases, and antibiotherapy alone should be considered only in selected cases. Further studies are needed to clarify diagnostic and treatment strategies based on the causative pathogens and patient status.

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来源期刊

Pace-Pacing and Clinical Electrophysiology 医学-工程：生物医学

CiteScore

2.70

自引率

5.60%

发文量

209

审稿时长

2-4 weeks

期刊介绍： Pacing and Clinical Electrophysiology (PACE) is the foremost peer-reviewed journal in the field of pacing and implantable cardioversion defibrillation, publishing over 50% of all English language articles in its field, featuring original, review, and didactic papers, and case reports related to daily practice. Articles also include editorials, book reviews, Musings on humane topics relevant to medical practice, electrophysiology (EP) rounds, device rounds, and information concerning the quality of devices used in the practice of the specialty.