# AF-ablatie na LAAO-implantatie is veilig; korte OAC-fase volstaat bij hoogbloedingsrisico

*geplaatst 2026-10-03 · Atriumfibrilleren · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · doi 10.1093/europace/euag277 · https://hartvaat.nl/2026/09/25/af-ablatie-na-laao-implantatie-is-veilig-korte-oac-fase-volstaat-bij-hoogbloedin/*

Een multicenterregister van 198 patiënten met een eerder geïmplanteerd LAAO-apparaat toont aan dat catheterablatie voor atriumfibrilleren veilig is en zelden apparaatgerelateerde complicaties geeft. Na de ingreep werd bij 84% van de patiënten kortdurend (2-3 maanden) anticoagulantia gebruikt; bloedingen traden op bij 6,7% en cerebrovasculaire incidenten bij 2,6%, wat overeenkomt met verwachte risico's in deze populatie. Voor de klinische praktijk betekent dit dat een korte OAC-fase na ablatie bij LAAO-patiënten goed verdraagbaar is zonder extra veiligheidsrisico's.

## English: Safety and Efficacy of Left Atrial Ablation After Percutaneous Left Atrial Appendage Occlusion in High-Bleeding-Risk Patients with Atrial Fibrillation: A Multicenter Analysis from the PROCEED-AF Ablation Registry.

A multicenter registry of 198 patients with a pre-existing LAAO device demonstrates that catheter ablation for atrial fibrillation is safe and rarely causes device-related complications. Following ablation, 84% of patients received short-term oral anticoagulation (typically 2–3 months), with bleeding occurring in 6.7% and stroke/TIA in 2.6%, aligning with expected risks in this high-bleeding-risk population. These findings support the use of a brief OAC course post-ablation in LAAO patients without compromising safety.

## Abstract (original, from the publication)

BACKGROUND AND AIMS: Patients with left atrial appendage (LAAO) devices are increasingly referred for AF ablation, yet anticoagulation strategies remain uncertain. The goal of this study was to evaluate the safety and efficacy of catheter ablation for atrial fibrillation (AF) in patients with pre-existing LAAO devices and to describe patterns in anticoagulation management after ablation in this unique population. METHODS: We collected data from 14 centers worldwide on patients with prior LAAO devices undergoing AF ablation. Each site provided clinical characteristics, procedural details, and information on complications and arrhythmia outcomes. Data were aggregated and analyzed centrally to evaluate procedural safety, efficacy, and variability in management strategies. RESULTS: A total of 198 patients (age 70 years, 37% female, 42% paroxysmal AF) with prior LAAO were included. Ablation was performed a median of 271 days after LAAO. After ablation, 84% of patients were on oral anticoagulation (OAC), most commonly for 2-3 months. Bleeding complications on OAC occurred in 6.7% of patients at a median of 20 (13, 70) days after ablation. Stroke or TIA occurred in 5 patients (2.6% of cases) within the follow-up period with 2 occurrences (1% of cases) the day after ablation. There were 2 cases of new or worsened peri-device leak after ablation. CONCLUSION: In a large, international registry of patients undergoing catheter ablation for AF with pre-existing LAAO devices, ablation was feasible and device related complications were rare Despite higher bleeding risk in an LAAO population, 84% of patients with prior LAAO tolerated short term OAC post-ablation with bleeding events at expected rates for this population.

Auteurs: Rachel M Kaplan, Jeanne du Fay de Lavallaz, Christian-Hendrik Heeger, Hakan Oral, Mason Yoder, David Schaack, Julian K Chun, Boris Schmidt, Jeffrey Winterfield, William H Sauer, Fernando Moreno, Jonathan W Waks, Antonio Dello Russo, Paolo Compagnucci, Pipin Kojodjojo, Ghanshyam Shantha, Laurent Roten, Tobias Reichlin, Thomas Kueffer, Kenneth Brownell, Smit C Vasaiwala, Timothy M Markman, Patrick Badertscher, Michael Kühne, Christian Sticherling, Nishant Verma, Graham Peigh, Bradley P Knight, Tom De Potter, Konstantia Paraskevi Gkini, Dhiraj Gupta, Mark T Mills, Serge Boveda, Robin Richard-Vitton, Jorge Romero, Fengxiang Zhang, Raktham Mekritthikrai, Henry D Huang

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Bron: Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, https://doi.org/10.1093/europace/euag277. Bijgewerkt 2026-09-26T01:28:03Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.