Abstract 11896: Percutaneous Left Atrial Appendage Closure is Reasonable Option for the Treatment of Patients With Atrial Fibrillation at High Risk for Cerebrovascular Events
Bibliographic record
Abstract
Introduction: Percutaneous left atrial appendage (LAA) closure is an emerging alternative intervention for anticoagulant treatment in patients with atrial fibrillation and high risk of cerebrovascular events. Only few data are available on the prognosis of patients treated with this new interventional strategy. Hypothesis: The aim of the multicenter prospective French national LAA Closure registry (FLAAC) was to report the results of this procedure in daily practice in France. Methods: Patients referred from October 2013 to September 2015 to 36 French centers for percutaneous LAA closure were prospectively included in this observational registry. We report here the results of the 436 first patients with one year follow-up. Results: The mean (±SEM) age of the study population was 75.5 ± 0.4 years and 62.2 percent were men. Their average CHA 2 DS 2 -VASc and HAS-BLED scores were 4.5 ± 0.1 and 3.1 ± 0.1, respectively. Fifty-height percent of patients were treated with an Amplatzer ™ LAA Occluder and 42% with a Watchman ™ device. LAA closure was successful in 98.4% of patients (including 9 patients requiring two procedures with a different device). The mean follow-up period was 12.7 ± 0.2 months after implantation of the device and only one patient was lost to follow-up. In patients with successful device implantation, ischemic stroke and cerebral hemorrhage rates were 0.22 and 0.11% per month during the follow-up period. The survival rate was 91.1% (38 deaths/429), with 7 (1.6 %) deaths related or possibly related to the device or to the procedure. Other causes of death were cerebral ischemic and hemorrhagic events (0.2% and 0.7%, respectively), major non-cerebral hemorrhagic events (0.7%), known or suspected cardiovascular diseases (2.3 %) and other preexisting non-cardiovascular comorbidities (3.3%). Conclusion: In conclusion, this national prospective registry shows that LAA closure is mainly used in patients with very high risk of cerebrovascular events. In this population, this procedure appears to be a reasonable option in daily practice. The high percentage of deaths related to comorbidities suggests that patient global clinical status should also be evaluated to assess patient eligibility before the procedure.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".