Study population
Patients with NVAF at a high risk of stroke who underwent LAmbre implants (Lifetech Scientific Corp., Shenzhen, China) at The First Affiliated Hospital of Wenzhou Medical University from January 2018 to December 2019 were included. The inclusion criteria for LAAC were as follows: age >18 years, CHA2DS2-VASc score ≥2, contraindication to long-term OAT, patients with bleeding events with or without anticoagulation therapy, stroke despite OAT, and intolerance or refusal to take OAT. The exclusion criteria were as follows: comorbid unstable angina or acute myocardial infarction, a left atrial inner diameter >65 mm, valvular heart disease, left atrial thrombus, a history of LAA ligation, a history of inferior vena cava filter placement surgery, severe infection, tumours, other diseases requiring systemic anticoagulation, new onset stroke events within 1 month, active bleeding disease, and a left ejection fraction ≤30%. The conventional implantation method was used in the LAAC procedure in the initial 59 patients (CM group) and an MM was used in the subsequent 165 patients (MM group). All patients received pre-procedural transesophageal echocardiography (TEE) to assess anatomy of the LAA and to exclude thrombus of the LAA. Written informed consent was obtained from all of the participants. The study was approved by the ethics committee of the local institution.