{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T00:14:31Z","timestamp":1793319271833,"version":"4.5.0"},"reference-count":43,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T00:00:00Z","timestamp":1694476800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T00:00:00Z","timestamp":1694476800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Freiburg"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Res Cardiol"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n              <jats:title>Background<\/jats:title>\n              <jats:p>New and refined catheter based left atrial appendage (LAA) closure devices have been introduced in the past decade. The procedure can be performed using either an endocardial occlusion device or an epicardial loop stitch. We aimed to analyzed recent procedural safety.<\/jats:p>\n            <\/jats:sec><jats:sec>\n              <jats:title>Methods<\/jats:title>\n              <jats:p>Catheter based LAA closures were identified in a complete nationwide German dataset via ICD and OPS codes from 2016 to 2020.<\/jats:p>\n            <\/jats:sec><jats:sec>\n              <jats:title>Results<\/jats:title>\n              <jats:p>From 2016 to 2020, 28,039 endocardial and 213 epicardial occlusions were performed. Numbers of endocardial procedures increased from 5259 in 2016 to 5917 in 2020 (p\u2009=\u20090.020) in 387 centers with shifting of patients\u2019 characteristics towards older age (\u03b2\u2009=\u20090.29, p\u2009&lt;\u20090.001), more heart failure (\u03b2\u2009=\u20091.01, p\u2009&lt;\u20090.001) and renal disease (\u03b2\u2009=\u20090.67, p\u2009=\u20090.001) and without a significant trend for in-hospital safety except more bleeding (\u03b2\u2009=\u20090.12, p\u2009=\u20090.05). In-hospital major adverse cardiac and cerebrovascular events (MACCE) or pericardial puncture were independent on center procedure numbers.<\/jats:p>\n              <jats:p>The loop stitch procedure was performed in 15 centers. Patients were younger (76.17\u2009\u00b1\u20098.16 vs. 73.16\u2009\u00b1\u20098.99, p\u2009&lt;\u20090.001) and had a lower comorbidity index (2.29\u2009\u00b1\u20091.93 vs. 1.92\u2009\u00b1\u20091.64, p\u2009=\u20090.005). Adjusted risk difference for pericardial effusion (8.04%; 95% CI 3.01\u201313.08%; p\u2009=\u20090.002) and pericardial puncture (6.60%; 95% CI 3.85\u20139.35%; p\u2009&lt;\u20090.001) was higher for the loop stitch procedure, while risk of bleeding (\u2212\u20091.85%; 95% CI \u2212\u20093.01 to \u2212\u20090.69%; p\u2009=\u20090.002), intracerebral bleeding (\u2212\u20090.37%; 95% CI \u2212\u20090.59 to \u2212\u20090.15%; p\u2009=\u20090.001) and shock (\u2212\u20091.41%; 95% CI \u2212\u20092.44 to \u2212\u20090.39%; p\u2009=\u20090.007) was lower. No significant difference was observed for in-hospital MACCE.<\/jats:p>\n            <\/jats:sec><jats:sec>\n              <jats:title>Conclusions<\/jats:title>\n              <jats:p>Endocardial occlusion was the major catheter based LAA closure procedure in Germany without improvements in in-hospital safety from 2016 to 2020. In-hospital MACCE was independent on endocardial LAAC center volumes. Conclusions on the comparison between the two procedure types must be made cautious as the LAA loop stitch occlusion was utilized limited in a minor number of centers.<\/jats:p>\n            <\/jats:sec><jats:sec>\n              <jats:title>Graphical abstract<\/jats:title>\n              <jats:p>Catheter based left atrial appendage closure in-hospital outcomes in Germany from 2016 to 2020<\/jats:p>\n              \n            <\/jats:sec>","DOI":"10.1007\/s00392-023-02299-w","type":"journal-article","created":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T14:02:15Z","timestamp":1694527335000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Catheter based left atrial appendage closure in-hospital outcomes in Germany from 2016 to 2020"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0200-7495","authenticated-orcid":false,"given":"Alexander","family":"Maier","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus","family":"Kaier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timo","family":"Heidt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"Westermann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Constantin","family":"von zur M\u00fchlen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Grundmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,9,12]]},"reference":[{"key":"2299_CR1","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1093\/eurheartj\/ehaa612","volume":"42","author":"G Hindricks","year":"2021","unstructured":"Hindricks G et al (2021) 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): the Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. 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