RT Journal Article
SR Electronic
T1 Percutaneous left atrial appendage occlusion for stroke prevention in atrial fibrillation: an update
JF Open Heart
JO Open Heart
FD British Cardiovascular Society
SP e000020
DO 10.1136/openhrt-2013-000020
VO 1
IS 1
A1 O De Backer
A1 S Arnous
A1 N Ihlemann
A1 N Vejlstrup
A1 E Jørgensen
A1 S Pehrson
A1 T D W Krieger
A1 P Meier
A1 L Søndergaard
A1 O W Franzen
YR 2014
UL http://openheart.bmj.com/content/1/1/e000020.abstract
AB Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia encountered in clinical practice. One of its most devastating complications is the development of thromboembolism leading to fatal or disabling stroke. Oral anticoagulation (OAC, warfarin) is the standard treatment for stroke prevention in patients with AF with an increased stroke risk. However, there are several obstacles to long-term OAC therapy, including the risk of serious bleeding, several drug–drug interactions and the need for frequent blood testing. Although newer oral anticoagulants have been developed, these drugs also face issues of major bleeding and non-compliance. Therefore, alternative treatment options for stroke prevention in patients with AF with a high stroke risk are needed. Percutaneous left atrial appendage (LAA) occlusion is an evolving therapy, which should be taken into consideration in those patients with non-valvular AF with a high stroke risk and contraindications for OAC. This article aims to discuss the rationale for LAA closure, the available LAA occlusion devices and their clinical evidence until now. Moreover, we discuss the importance of proper patient selection, the role of various imaging techniques and the need for a more tailored postprocedural antithrombotic therapy.