ArticleEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2024
Incidence and predictors of 2-year mortality following percutaneous left atrial appendage occlusion in the EWOLUTION trial.
Article in Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01972282 (Registry on WATCHMAN Outcomes in Real-Life Utilization), which is not on this map. Cited by 14 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Registry on WATCHMAN Outcomes in Real-Life Utilization
Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Long-term efficacy and safety of left atrial appendage closure vs. oral anticoagulation in atrial fibrillation: a meta-analysis of randomized controlled trials.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026Pooled it
- [Update of the ESC atrial fibrillation guidelines : From the DGK commission for clinical cardiovascular medicine].Herzschrittmachertherapie & Elektrophysiologie · 2025Guideline
- Bleeding-related conditions, procedural safety, and mortality after left atrial appendage closure.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026Article
- Left atrial appendage closure in patients with atrial fibrillation: grey zones involving trials, meta-analysis, and decision-making.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026Article
- More than an OPTION: left atrial appendage closure beyond high bleeding risk in the post-ablation setting.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026Article
- Outcomes of simplified left atrial appendage occlusion using the WATCHMAN FLX device: the ROSE-FLX study.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026Article
- Three-year clinical outcomes of left atrial appendage occlusion with or without ablation: insight from the RECORD study.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026Observational
- Left atrial appendage occlusion in patients with atrial fibrillation and major gastrointestinal bleeding: outcomes from a multi-hospital health system.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026Article
- Left atrial appendage occlusion vs standard of care in high stroke risk atrial fibrillation patients ineligible for anticoagulation: COMPARE-LAAO.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2026Article
- Percutaneous Left Atrial Appendage Closure: Current Evidence and Procedural Insights.Reviews in cardiovascular medicine · 2025Review
- Comparative outcomes of left atrial appendage occlusion with and without catheter ablation: a 5-year propensity-matched analysis.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Article
- Blood transfusion in percutaneous left atrial appendage occlusion: a nationwide analysis of incidence, predictors, and outcomes.BMC cardiovascular disorders · 2025Article
- Long-term outcomes of left atrial appendage closure techniques on stroke prevention of recurrent atrial fibrillation patients: epicardial excision versus percutaneous occlusion.Frontiers in cardiovascular medicine · 2025Article
- Left atrial appendage occlusion: are we ready for prime time?Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024Article
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Authors and funding
18 authors.
Funding
Abstract
aimsSufficient survival time following left atrial appendage occlusion (LAAO) is essential for ensuring the efficacy and cost-effectiveness of this strategy for stroke prevention. Understanding prognostic factors for early mortality after LAAO could optimize patient selection. In the current study, we perform an in-depth analysis of 2-year mortality after LAAO, focusing particularly on potential predictors. METHODS AND
resultsThe EWOLUTION registry is a real-world cohort comprising 1020 patients that underwent LAAO. Endpoint definitions were pre-specified, and death was categorized as cardiovascular, non-cardiovascular, or unknown origin. Mortality rates were calculated from Kaplan-Meier estimates. Baseline characteristics significantly associated with death in univariate Cox regression analysis were incorporated into the multivariate analysis. All multivariate predictors were included in a risk model. Two-year mortality rate was 16.4% [confidence interval (CI): 14.0-18.7%], with 50% of patients dying from a non-cardiovascular cause. Multivariate baseline predictors of 2-year mortality included age [hazard ratio (HR) 1.05, CI: 1.03-1.08, per year increase], heart failure (HR 1.73, CI: 1.24-2.41), vascular disease (HR 1.47, CI: 1.05-2.05), valvular disease (HR 1.63, CI: 1.15-2.33), abnormal liver function (HR 1.80, CI: 1.02-3.17), and abnormal renal function (HR 1.58, CI: 1.10-2.27). Mortality rate exhibited a gradual rise as the number of risk factors increased, reaching 46.1% in patients presenting with five or six risk factors.
conclusionOne in six patients died within 2 years after LAAO. We identified six independent predictors of mortality. When combined, this model showed a gradual increase in mortality rate with a growing number of risk factors, which may guide appropriate patient selection for LAAO. CLINICAL
trial registrationThe original EWOLUTION registry was registered at clinicaltrials.gov under identifier NCT01972282.
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