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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Left Atrial Appendage Exclusion for Atrial Fibrillation
Faisal F Syed1, Christopher V DeSimone1, Paul A Friedman1
1Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA.
Insights
Percutaneous left atrial appendage closure offers stroke prevention for atrial fibrillation patients unable to use anticoagulants. This review covers surgical and device-based methods, stroke risks, and procedural considerations.
Area of Science:
- Cardiology
- Interventional Cardiology
- Stroke Prevention
Background:
- Atrial fibrillation (AF) increases stroke risk, particularly from the left atrial appendage (LAA).
- Anticoagulant therapy is standard but contraindicated in some AF patients.
- Left atrial appendage closure is an alternative stroke prevention strategy.
Purpose of the Study:
- To review current surgical and percutaneous left atrial appendage closure techniques.
- To discuss stroke mechanisms in AF and the role of LAA.
- To compare procedural approaches and clinical management.
Main Methods:
- Review of published studies on LAA closure.
- Focus on stroke mechanisms, LAA anatomy and function.
- Analysis of procedural techniques and clinical outcomes.
Main Results:
- Various percutaneous and surgical LAA closure devices and methods exist.
- Understanding LAA structure and function is crucial for effective stroke prevention.
- Procedural nuances and patient management strategies vary.
Conclusions:
- Left atrial appendage closure is a growing option for stroke risk reduction in specific AF populations.
- Further research and standardization of techniques are ongoing.
- This review provides a comprehensive overview for clinicians.
Abstract:
Percutaneous left atrial appendage (LAA) closure is being increasingly used as a treatment strategy to prevent stroke in patients with atrial fibrillation (AF) who have contraindications to anticoagulants. Several approaches and devices have been developed in the last few years, each with their own unique set of advantages and disadvantages. In this article, the published studies on surgical and percutaneous approaches to LAA closure are reviewed, focusing on stroke mechanisms in AF, LAA structure and function relevant to stroke prevention, practical differences in procedural approach, and clinical considerations surrounding management.
