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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
34.2K
[Left atrial appendage occlusion for atrial fibrillation]
Marco Roberto1, Amir-Ali Fassa2, Edoardo De Benedetti2
1Département de médecine interne, Hôpital du Jura, 2800 Delémont.
Revue Medicale Suisse
|July 18, 2017
Summary
Left atrial appendage occlusion is an alternative for preventing embolic stroke in atrial fibrillation (AF) patients at high risk for bleeding. This procedure may reduce stroke risk when oral anticoagulation is contraindicated.
Area of Science:
- Cardiology
- Neurology
- Vascular Surgery
Background:
- Atrial fibrillation (AF) significantly increases embolic stroke risk.
- Oral anticoagulation is standard for thromboembolic (TE) prophylaxis but raises bleeding concerns.
- The left atrial appendage is the primary source of thrombi in AF patients.
Purpose of the Study:
- To evaluate left atrial appendage occlusion as an alternative TE prophylaxis in AF.
- To assess the efficacy and safety of percutaneous left atrial appendage occlusion.
Main Methods:
- Review of registries and randomized trials on left atrial appendage occlusion.
- Analysis of TE risk (CHADS2VASc score) and bleeding risk (HAS-BLED score).
Main Results:
- Left atrial appendage occlusion reduces embolic risk.
- The procedure is considered for patients with high TE and bleeding risks (CHADS2VASc ≥ 2, HAS-BLED ≥ 3).
- Existing trials exclude patients unable to take oral anticoagulants.
Conclusions:
- Percutaneous left atrial appendage occlusion is a viable option for TE prophylaxis in specific AF patient groups.
- Further research is needed for patients with contraindications to oral anticoagulants.
