Abstract 4140981: In-Hospital Outcomes of Left Atrial Appendage Occlusion (LAAO) among patients with Atrial Fibrillation and Hematological Malignancy; Insight from The National Inpatient Database (2015-2020)

Introduction/Background: Patients with hematological malignancies are at a higher risk of developing atrial fibrillation. Additionally, it can predispose to an increased risk of bleeding limiting anticoagulation for stroke prevention. LAAO has been successfully utilized among patients with atrial fibrillation and contraindication to anticoagulation. Research Question: What are the outcomes and in-hospital complications of left atrial appendage occlusion (LAAO) among patients with atrial fibrillation and hematological malignancy? Methods: The National Inpatient Sample (NIS) was analyzed from 2015-2020 to identify admissions for LAAO among patients with and without a hematological malignancy. Baseline characteristics were compared between the two groups and multivariate logistic regression was used to analyze hospitalization outcomes. Results: We identified 89,920 weighted admissions for LAAO procedures of which 1,665 patients (1.85%) had a hematological malignancy. In the adjusted analysis, the odds of MACCE (aOR 1.86, 95% CI 1.10-3.14, p 0.0205), cardiogenic shock (aOR 3.76, 95% CI 1.95-7.24, p <0.001), cardiac tamponade (aOR 2.42, 95% CI 1.61-3.65, p <0.001), pericardial drainage (aOR 2.54, 95% CI 1.50-4.29, p 0.005), ventricular arrhythmia (aOR 1.61, 95% CI 1.14-2.27, p 0.00061), and AKI (aOR 1.58, 95% CI 1.22-2.03, p 0.0004) was higher in the hematological malignancy cohort. Conclusion: The presence of a hematological malignancy was associated with higher rates of MACCE and other periprocedural complications among patients undergoing LAAO. These complications should be taken into account during clinical decision making and management of these patients.