To evaluate the efficacy and safety of left atrial appendage occlusion (LAAO) in patients with atrial fibrillation (AF) over 75 years. A total of 82 patients with AF who underwent LAAO successfully in Beijing Anzhen Hospital from March 2014 to March 2019 were divided into two groups according to age: the elderly group (aged>75 years) and the young group (aged ≤75 years). Risk of perioperative complications and incidence of ischemic stroke and major bleeding during follow-up were retrospectively analyzed. The results showed that there were no significant differences in procedure-related ischemic stroke(0 vs.1.6%,P=0.768) and major bleeding (0 vs.1.6%,P=0.768) during perioperative period between the two groups. No complications as death or pericardial tamponade occurred in the two group. During a (25.9±15.9) months period of followed up, ischemic stroke event rate was 3.6/100 person-years in the elderly group and 4.9/100 person-years in the young group, respectively. Major bleeding event rate was 2.5/100 person-years in the elderly group and 0/100 person-years in the young group, respectively. Compared with the expected ones, the relative risk reduction (RRR) of stroke in the elderly group was more profound than that in the young group (32.0% vs. 25.0%), while the risk of major bleeding in the young group was significantly lower than that in the elderly group (RRR 100% vs. 56.9%). Therefore, LAAO might be suitable for stroke prevention in the elderly AF patients.
评价75岁以上心房颤动（房颤）患者行经皮左心耳封堵术预防卒中的有效性和安全性。将2014年3月至2019年3月在北京安贞医院心内科成功接受左心耳封堵术治疗的82例房颤患者分为高龄组（年龄>75岁）与非高龄组，回顾性分析两组围术期并发症以及长期随访期间缺血性卒中、大出血等事件发生率。结果显示，高龄组与非高龄组围术期手术相关缺血性卒中（0比1.6%，P=0.768）及大出血发生率（0比1.6%，P=0.768）差异均无统计学意义。两组均未出现死亡、心包填塞等并发症。随访（25.9±15.9）个月，高龄组与非高龄组缺血性卒中发生率分别为3.6/100人年和4.9/100人年，大出血发生率分别为2.5/100人年和0/100人年。与预期风险相比，高龄组发生卒中的相对风险较非高龄组降低更多（32.0%比25.0%）；而非高龄组大出血相对风险下降更多（100%比56.9%）。左心耳封堵术可能是老年房颤患者预防卒中的合理选择。.