Left Atrial Appendage Occlusion (LAAO)
The Structural Heart Intervention Registries are within the National Cardiac Audit Programme (NCAP). There are four structural heart intervention registeries including Left Atrial Appendage Occlusion (LAAO).
Structural heart disease is a term for a number of defects which affect the valves and chambers of the heart and the aorta. Some defects are present at birth (congenital) while others form later in life. If a defect is identified, treatments will be offered and will vary depending on the type and severity of the condition.
Atrial fibrillation (AF), the irregular and rapid beating of the heart, can lead to the development of congestive heart failure.
Current treatment includes:
- controlling the rate and rhythm of the heart with medication
- a medically administered electric shock to the heart, known as cardioversion
- correcting electrical signal pathways in the heart by catheter ablation
- fitting a pacemaker to control the heart beat more regularly
AF patients have an increased risk of stroke; clots can form when the heart is not pumping effectively. The left atrial appendage (LAA), a long tubular hooked structure with a narrow junction where it joins the atrium of the heart, is an area of the heart where blood collects and begins to clot in patients with AF. Closing the LAA could prevent these clots from entering the circulatory system and causing complications such as stroke. The risk of stroke in patients with atrial fibrillation is thought to be reduced by blocking the left atrial appendage.
The devices being evaluated in this registry are the Watchman device and the Amplatzer cardiac plug.
The aim of the audit is to collect clinical and outcome data on structural heart intervention services carried out in the UK. This is a significant development and will enable identification of key metrics for benchmarking, improving care of patients undergoing these procedures and for the safe introduction of new technologies in this country. The audit is managed by NICOR, with clinical direction and strategy provided by national professional societies.
- Current evidence suggests that percutaneous occlusion of the left atrial appendage (LAA) is efficacious in reducing the risk of thromboembolic complications associated with non-valvular atrial fibrillation (AF). With regard to safety, there is a risk of life-threatening complications from the procedure, but the incidence of these is low. Therefore, this procedure may be used provided that normal arrangements are in place for clinical governance, consent and audit.