A Current Perspective on Left Atrial Appendage Closure Device Infections: A Systematic Review
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Wiley
2025
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| author | Yusuf Ziya Sener Sumeyye Fatma Ozer Gizem Karahan |
| author_facet | Yusuf Ziya Sener Sumeyye Fatma Ozer Gizem Karahan Yusuf Ziya Sener Sumeyye Fatma Ozer Gizem Karahan |
| collection | Wiley Open Access |
| contents | A Current Perspective on Left Atrial Appendage Closure Device Infections: A Systematic Review Yusuf Ziya Sener Sumeyye Fatma Ozer Gizem Karahan Pacing and Clinical Electrophysiology ABSTRACTPurposeLeft 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.MethodsA 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.ResultsThe 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.ConclusionLAA 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. 10.1111/pace.15184 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| doi_str_mv | 10.1111/pace.15184 |
| format | Artículo Open Access |
| id | wiley_oa_10_1111_pace_15184 |
| institution | Wiley Open Access |
| license_str_mv | http://onlinelibrary.wiley.com/termsAndConditions#vor |
| publishDate | 2025 |
| publisher | Wiley |
| record_format | wiley_oa |
| spellingShingle | A Current Perspective on Left Atrial Appendage Closure Device Infections: A Systematic Review Yusuf Ziya Sener Sumeyye Fatma Ozer Gizem Karahan Pacing and Clinical Electrophysiology A Current Perspective on Left Atrial Appendage Closure Device Infections: A Systematic Review Yusuf Ziya Sener Sumeyye Fatma Ozer Gizem Karahan Pacing and Clinical Electrophysiology ABSTRACTPurposeLeft 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.MethodsA 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.ResultsThe 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.ConclusionLAA 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. 10.1111/pace.15184 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| title | A Current Perspective on Left Atrial Appendage Closure Device Infections: A Systematic Review |
| topic | Pacing and Clinical Electrophysiology |
| url | https://onlinelibrary.wiley.com/doi/10.1111/pace.15184 |