Evidence map›Paper›PMID 40879386›Full record

SynthesisEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2025

Left atrial appendage occlusion in patients with end-stage renal disease: an individual patient-level meta-analysis.

Juan F Rodriguez-Riascos, Hema S Vemulapalli, Ibrahim Akin, Luis A Areiza, Domenico G Della Rocca, Ingo Eitel, Thomas Fink, Simonetta Genovesi, Joelle Kefer, David Zweiker and 2 more

Abstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis 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, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. 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 · 2026
    Pooled it
  2. 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 · 2026
    Article
  3. Article
  4. Review
  5. Review
  6. A double paradox: end-stage renal disease-high thromboembolic and bleeding risk management using a device with risks of thromboembolism and bleeding.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 · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Juan F Rodriguez-RiascosDivision of Cardiovascular Diseases, Mayo Clinic, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USA.ORCID 0000-0002-8271-9128
Hema S VemulapalliDivision of Cardiovascular Diseases, Mayo Clinic, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USA.ORCID 0009-0001-2942-1031
Ibrahim AkinDepartment of Invasive Cardiology and Electrophysiology, Deputy Director of the First Department of Medicine, Head of Cardiovascular Research, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.ORCID 0000-0003-1974-6147
Luis A AreizaDepartment of Invasive Cardiology, Hospital Universitario Mayor, Mederi, Bogotá, Colombia.ORCID 0000-0002-5397-2263
Domenico G Della RoccaTexas Cardiac Arrhythmia Institute, St.David's Medical Center, Austin, TX, USA.ORCID 0000-0003-3837-3462
Ingo EitelDepartment of Cardiology, Angiology and Intensive Care Medicine-Division of Electrophysiology, University Heart Center Lübeck, Lübeck, Germany.ORCID 0000-0002-6442-246X
Thomas FinkClinic for Electrophysiology, Herz- und Diabeteszentrum NRW, Ruhr University Bochum, Bad Oeynhausen, Germany.ORCID 0000-0002-6665-7326
Simonetta GenovesiSchool of Medicine and Surgery, Nephrology Clinic, University of Milano-Bicocca, Milan, Italy.ORCID 0000-0002-4699-4149
Joelle KeferDivision of Cardiology, Cliniques Universitaires Saint-Luc et Pôle de Recherche Cardiovasculaire, Institut de Recherche Expérimentale et Clinique, (IREC), Université Catholique de Louvain (UCLouvain), Brussels, Belgium.ORCID 0000-0001-8338-908X
David ZweikerDepartment of Cardiology, Medical University of Graz, Graz, Austria.ORCID 0000-0002-7479-7767
Poojan PrajapatiDivision of Cardiovascular Diseases, Mayo Clinic, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USA.ORCID 0009-0005-4959-1344
Komandoor SrivathsanDivision of Cardiovascular Diseases, Mayo Clinic, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USA.ORCID 0000-0001-9732-0243

Funding

Mayo Clinic Arizona Cardiovascular Clinical Research Center
6 · The paper itself

Abstract

aimsPatients with end-stage renal disease (ESRD) and atrial fibrillation present a challenge for thromboembolic prevention, given their elevated risks of both thromboembolism and bleeding. Anticoagulants carry a higher bleeding risk in this population without clear evidence of thromboembolic benefit. This study aims to define the role of left atrial appendage occlusion (LAAO) as a preventive strategy for patients with ESRD. METHODS AND

resultsA systematic literature review was conducted to identify studies reporting outcomes in patients with ESRD who underwent LAAO. Meta-analyses of aggregate and individual patient data were performed to evaluate acute and long-term outcomes and compare them with those of patients without ESRD. Seventeen studies reporting data from 24 127 patients, including 1047 with ESRD, were included. Procedural complications were more common in patients with ESRD (RR 2.23; P = 0.02), with a pooled rate of 4% (95% CI, 1-9%). There was no significant difference in thromboembolic event rates during follow-up between the groups (IRR 1.44; P = 0.16), but major bleeding incidence was higher among patients with ESRD (IRR 1.84; P < 0.01). Individual patient-level data from seven studies comprising 4745 patients (268 with ESRD) were obtained and analysed. Similarly, there was no significant association between ESRD and stroke/TIA incidence (HR, 1.22; 95% CI, 0.66-2.26), but major bleeding was higher on patients with ESRD (HR, 1.65; 95% CI, 1.01-2.69).

conclusionLAAO represents a feasible option for thromboembolic prevention in patients with ESRD, although these patients have an increased risk of complications and bleeding.

Indexed as

Atrial AppendageAtrial FibrillationCardiac CatheterizationKidney Failure, ChronicStrokeThromboembolismAgedFemaleHemorrhageHumansIncidenceMaleMiddle AgedRisk FactorsTime FactorsTreatment OutcomeAtrial fibrillationLeft atrial appendage occlusionStroke

Identifiers

PMID40879386
PMCPMC12548373

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.