{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T15:10:01Z","timestamp":1777734601526,"version":"3.51.4"},"reference-count":25,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:00:00Z","timestamp":1756339200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:00:00Z","timestamp":1756339200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Percutaneous left atrial appendage closure (LAAC) reduces the risk of thromboembolic stroke in patients with non\u2010valvular atrial fibrillation who cannot tolerate long\u2010term oral anticoagulation. However, outcomes after LAAC in patients requiring chronic immunosuppressive therapy (IMS) remain unknown. This study aimed to investigate the perioperative and long\u2010term outcomes of percutaneous LAAC in patients receiving chronic IMS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p>\n                      Patients who underwent LAAC were retrospectively evaluated according to the presence of long\u2010term IMS therapy. Perioperative complications, clinical outcomes, and device follow\u2010up characteristics were evaluated. From November 2017 to March 2023, a total of 1172 patients who underwent LAAC were included (69.3% male, 74.8 years), of whom 74 were taking IMS. The most common reasons for IMS use were rheumatoid arthritis (50.0%), followed by kidney transplantation (17.6%). There were no significant differences in intraoperative complications between the IMS group and the non\u2010IMS group. (1.4% vs. 1.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.943). During 617 [IQR: 373\u20131046] days, the incidence of systemic infections was higher in the IMS group (25.0% vs. 6.1%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). There were no significant differences in peri\u2010device leak (PDL) or device\u2010related thrombus, but the IMS group had a lower percentage of patients with improvement of PDL during follow\u2010up (8.3% vs. 50.0%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Successful LAAC in patients on IMS was achieved without increasing perioperative complications. Patients on chronic IMS did have an increased occurrence of systemic infections during long\u2010term follow\u2010up. The presence of IMS use was negatively associated with PDL improvement during follow\u2010up.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jce.70080","type":"journal-article","created":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T05:25:43Z","timestamp":1756445143000},"page":"2979-2989","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Immunosuppressive Drugs on Patients With Percutaneous Left Atrial Appendage Occlusion"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0663-7574","authenticated-orcid":false,"given":"Daisuke","family":"Togashi","sequence":"first","affiliation":[{"name":"Cardiovascular Division, Department of Medicine Vanderbilt University Medical Center Nashville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7333-5720","authenticated-orcid":false,"given":"Christopher R.","family":"Ellis","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Department of Medicine Vanderbilt University Medical Center Nashville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2055-732X","authenticated-orcid":false,"given":"Zachary T.","family":"Yoneda","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Department of Medicine Vanderbilt University Medical Center Nashville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jackon G.","family":"Gregory","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Department of Medicine Vanderbilt University Medical Center Nashville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8765-8961","authenticated-orcid":false,"given":"Shunsuke","family":"Uetake","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Department of Medicine Vanderbilt University Medical Center Nashville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salah H.","family":"Alahwany","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Department of Medicine Vanderbilt University Medical Center Nashville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael T.","family":"Baker","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Department of Medicine Vanderbilt University Medical Center Nashville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arvindh N.","family":"Kanagasundram","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Department of Medicine Vanderbilt University Medical Center Nashville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,8,28]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.04.029"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2015.08.035"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2013-004587"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.21841"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.82.6.704"},{"issue":"2","key":"e_1_2_11_7_1","first-page":"310","article-title":"Effects of Glucocorticoid on Connective Tissue of Aorta and Skin in Rabbits. 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