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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
34.6K
Left atrial appendage closure: a new technique for clinical practice
A John Camm1, Antonio Colombo2, Giorgio Corbucci3
1Clinical Sciences, St. George's University of London, London, United Kingdom.
Heart Rhythm
|December 3, 2013
Summary
Left atrial appendage (LAA) occlusion devices offer a stroke risk reduction alternative to anticoagulation for patients with atrial fibrillation (AF) and high bleeding risk. Long-term data shows superiority over warfarin.
Area of Science:
- Cardiology
- Medical Devices
- Interventional Procedures
Background:
- Atrial fibrillation (AF) is a common arrhythmia increasing stroke risk via cardiac embolism from the left atrial appendage (LAA).
- LAA occlusion devices provide an alternative to oral anticoagulation for high-risk bleeding patients.
- The WATCHMAN endocardial device shows promising results for stroke risk reduction and implant success.
Purpose of the Study:
- To review surgical and transcatheter devices for LAA closure (LAAC).
- To evaluate the efficacy and safety of LAA occlusion techniques.
Main Methods:
- Review of relevant publications on LAA closure devices.
- Analysis of data from prospective trials like PROTECT-AF.
Main Results:
- PROTECT-AF showed LAA occlusion with WATCHMAN was noninferior to warfarin in nonvalvular AF patients.
- Long-term (4-year) PROTECT-AF results indicated LAAC was statistically superior to warfarin in efficacy.
- Most studies focus on comparing closure techniques and success rates.
Conclusions:
- LAA closure techniques are appropriate for AF patients at high stroke risk.
- Consider LAAC when conventional or novel anticoagulation is unavailable or difficult to manage.
