Atrial fibrillation is not associated with thromboembolism in left ventricular assist device patients: A systematic review and meta-analysis

Veraprapas Kittipibul, Pattara Rattanawong, Jakrin Kewcharoen, Pakawat Chongsathidkiet, Wasawat Vutthikraivit, Napatt Kanjanahattakij

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Atrial fibrillation (AF) is a well-established risk factor of thromboembolism (TE). Thromboembolism is one of the most common complications in patients supported by continuousflow left ventricular assisted devices (CF-LVADs). However, the association between AF and TE complications in this population is controversial. We conducted a systematic review and meta-analysis to assess the association between AF and overall TE, stroke, and device thrombosis events in CF-LVAD patients. We performed a comprehensive literature search through September 2017 in the databases of MEDLINE and EMBASE. Included studies were prospective or retrospective cohort studies that compared the risk of developing overall TE, stroke, and device thrombosis events in CF-LVAD patients with AF and those without AF. We calculated pooled risk ratio (RR) with 95% confidence intervals (CI) and I2 statistic using the random-effects model. Eleven studies were included involving 6,351 patients who underwent CF-LVAD implantation. Overall, TE outcome was available in four studies involving 1,106 AF and 3,556 non-AF patients. Stroke outcome was available in seven studies (1,455 AF and 4,037 non-AF patients). Device thrombosis outcome was available in three studies (1,010 AF and 3,327 non-AF patients). There was no association between AF and TE events (RR = 0.95; 95% CI: 0.57-1.59, I2 = 79%, p = 0.85), stroke (RR = 1.10; 95% CI: 0.74-1.64, I2 = 73%, p = 0.65), and device thrombosis (RR = 0.97; 95% CI: 0.56-1.67, I2 = 42%, p = 0.91). AF in CF-LVAD patients was not associated with overall TE, stroke, or device thrombosis events. These findings might be explained by the highly thrombogenic property of CF-LVADs that exceeds the thromboembolic risk driven by AF.

Original languageEnglish
Pages (from-to)456-464
Number of pages9
JournalASAIO Journal
Volume65
Issue number5
DOIs
StatePublished - 2019
Externally publishedYes

Keywords

  • Atrial fibrillation
  • Device thrombosis
  • Left ventricular assisted device
  • Stroke
  • Thromboembolism

Fingerprint

Dive into the research topics of 'Atrial fibrillation is not associated with thromboembolism in left ventricular assist device patients: A systematic review and meta-analysis'. Together they form a unique fingerprint.

Cite this