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The source of a cardioembolic event is a thrombus, which forms in the left atrial appendage (LAA). Previous studies have suggested LAA occlusion (LAAO) is a safe and feasible way to prevent stroke. LAAO has being increasingly performed in the recent years. LAA plays an important role in regulation of intravascular volume via release of neurohormones, which regulate blood pressure. We retrospectively studied the blood pressure changes after LAAO in atrial fibrillation (AF) patients who successfully received LAAO in our hospital from June 2014 to June 2015.
We enrolled 44 patients with nonvalvular atrial fibrillation and contraindication to long-term oral anticoagulation or at high-risk of bleeding who successfully received percutaneous LAAO treatment in Sir Run Run Shaw hospital from June 2014 to June 2015. The office blood pressure before and 24 h after LAAO were collected. Additionally, serial office blood pressures (BPs) at 1 and 3 months after LAAO were also recorded.
In 44 patients, there were both significant reductions in office systolic BP (127.0±17.9 vs. 117.0±10.8; p< 0.001) and diastolic BP at 24 h (76.0±13.7 vs. 69.0±11.2; p<0.001). Among patients with hypertension (n=32), the office BP at 24 h after LAAO both with systolic BP from 130.6±18.2 to 117.8 ±11.1mmHg and diastolic BP from 78.0 ±13.3 to 69.2 ± 11.5 mmHg respectively p<0.001. Among hypertensive patients, 4 patients had their antihypertensive drugs reduced 24h post LAAO, 4 patients had their antihypertensive drugs reduced during the follow up and 1 patient had their antihypertensive drugs stopped during the follow up. However, among patients without hypertension (n=12), no significance of average systolic and diastolic BP was found at 24 h after LAAO and during the follow up.
An early decrease in blood pressure was observed after left atrial appendage occlusion. The clinical consequences and mechanism of these findings warrant further investigation.