ArticleClinical research in cardiology : official journal of the German Cardiac Society2023
Symptomatic vs. non-symptomatic device-related thrombus after LAAC: a sub-analysis from the multicenter EUROC-DRT registry.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed, 7 citations in OpenAlex.
- Clinical and subclinical acute brain injury caused by invasive cardiovascular procedures.Nature reviews. Cardiology · 2025Review
- Catheter based left atrial appendage closure in-hospital outcomes in Germany from 2016 to 2020.Clinical research in cardiology : official journal of the German Cardiac Society · 2024Article
- First-in-human left atrial appendage closure using the WATCHMAN FLX Pro device: a case report.European heart journal. Case reports · 2024Article
- Safety of dobutamine or adenosine stress cardiac magnetic resonance imaging in patients with left ventricular thrombus.Clinical research in cardiology : official journal of the German Cardiac Society · 2024Article
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Authors and funding
48 authors at 20 institutions in 8 countries.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundDevice-related thrombus (DRT) after left atrial appendage closure (LAAC) is associated with adverse outcomes, i.e. ischemic stroke or systemic embolism (SE). Data on predictors of stroke/SE in the context of DRT are limited.
aimsThis study aimed to identify predisposing factors for stroke/SE in DRT patients. In addition, the temporal connection of stroke/SE to DRT diagnosis was analyzed.
methodsThe EUROC-DRT registry included 176 patients, in whom DRT after LAAC were diagnosed. Patients with symptomatic DRT, defined as stroke/SE in the context of DRT diagnosis, were compared against patients with non-symptomatic DRT. Baseline characteristics, anti-thrombotic regimens, device position, and timing of stroke/SE were compared.
resultsStroke/SE occurred in 25/176 (14.2%) patients diagnosed with DRT (symptomatic DRT). Stroke/SE occurred after a median of 198 days (IQR 37-558) after LAAC. In 45.8% stroke/SE occurred within one month before/after DRT diagnosis (DRT-related stroke). Patients with symptomatic DRT had lower left ventricular ejection fractions (50.0 ± 9.1% vs. 54.2 ± 11.0%, p = 0.03) and higher rates of non-paroxysmal atrial fibrillation (84.0% vs. 64.9%, p = 0.06). Other baseline parameters and device positions were not different. Most ischemic events occurred among patients with single antiplatelet therapy (50%), however, stroke/SE was also observed under dual antiplatelet therapy (25%) or oral anticoagulation (20%).
conclusionStroke/SE are documented in 14.2% and occur both in close temporal relation to the DRT finding and chronologically independently therefrom. Identification of risk factors remains cumbersome, putting all DRT patients at substantial risk for stroke/SE. Further studies are necessary to minimize the risk of DRT and ischemic events.
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