Effect of Left Atrial Appendage Closure on Cardiac Function

Abstract

Atrial fibrillation (AF) is the most common clinically significant cardiac arrhythmia with a marked age-related increase in prevalence. Current guidelines recommend left atrial appendage closure (LAAC) as an alternative to long-term oral anticoagulation in selected patients at high-risk of both thromboembolic and bleeding events. Although the use of LAAC has increased substantially in recent years, its effects on cardiac function and post-procedural functional recovery remain incompletely understood. Therefore, this study aimed to evaluate changes in periprocedural cardiac function and functional parameters in patients with AF who underwent LAAC while receiving guideline-directed medical therapy. A retrospective cohort study was performed in 250 patients who underwent percutaneous LAAC at Lanzhou University Second Hospital between May 2019 and July 2025. A total of 162 patients were included in the final analysis. Echocardiographic parameters, NYHA functional class, and Barthel Index scores were compared before and after the procedure. Significant improvements were observed in several echocardiographic parameters. Post-procedural changes in NYHA functional class distribution and Barthel Index scores indicated improved functional status, with no evidence of deterioration in cardiac structure or function. These findings support the safety of LAAC with respect to cardiac functional recovery and demonstrate that the procedure does not adversely affect cardiac performance in patients with AF receiving guideline-directed medical therapy. Nevertheless, further large-scale, multi-center prospective studies are warranted to clarify the mechanisms underlying the observed improvements in cardiac function following LAAC.