Feasibility of concomitant left atrial appendage closure and percutaneous coronary intervention in patients with acute coronary syndrome and atrial fibrillation: a randomized pilot study

The optimal approach for prevention of cardiovascular events and reduction of bleeding in patients with acute coronary syndrome (ACS) and atrial fibrillation (AF) is still controversial. The aim of our study is to asses our single-center experience with concomitant left atrial appendage occlusion (LAAO) and percutaneous coronary intervention (PCI). 50 patients with ACS without ST elevation and history of AF were randomized after successful PCI to LAAO or conventional medical therapy. The primary endpoints were safety and length of hospitalization. The follow-up period was 30 days. The mean procedural times were 113 ± 23 min PCI + LAAO implantation and 39 ± 19 min of PCI only ( p < 0.001), while mean fluoroscopy times were 18 ± 8 min and 12 ± 8 min ( p < 0.001), respectively. No procedure-related complications were observed . There was no difference observed for length of hospitalization between two groups. LAAO in patients with ACS and AF undergoing PCI appears safe. Graphical abstract