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[Catheter-based atrial appendage closure-current data and future developments].

C Skurk1,2, J J Hartung1,2, D M Leistner1,2,3

  • 1Klinik für Kardiologie, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12003, Berlin, Deutschland.

Der Internist
|September 6, 2018
PubMed
Summary
This summary is machine-generated.

Atrial fibrillation (AF) affects over 1.6 million in Germany, increasing stroke risk. Left atrial appendage closure offers an alternative stroke prevention strategy for patients ineligible for anticoagulation.

Keywords:
AnticoagulantsAtrial fibrillationHemorrhageStroke preventionVitamin K antagonists

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Area of Science:

  • Cardiology
  • Medical Technology

Background:

  • Atrial fibrillation (AF) impacts over 1.6 million Germans, with numbers projected to rise due to an aging population.
  • Untreated AF significantly elevates stroke risk (5x higher than controls).
  • New oral anticoagulants (NOACs) effectively reduce stroke risk by 70-80%.

Purpose of the Study:

  • To review alternative stroke prevention strategies for atrial fibrillation patients.
  • To discuss catheter-based percutaneous left atrial appendage closure as an option for high-bleeding-risk patients.
  • To analyze current data on the efficacy and safety of left atrial appendage closure.

Main Methods:

  • Review of current data on left atrial appendage closure.
  • Discussion of patient eligibility for anticoagulation based on risk scores (CHA2DS2-VASc, HAS-BLED).
  • Analysis of ongoing randomized studies for catheter-based interventions.

Main Results:

  • A significant percentage of AF patients (20-30%) are not candidates for long-term anticoagulation due to high bleeding risk.
  • Left atrial appendage closure presents a viable alternative for stroke prevention in this population.
  • Current data on the safety and efficacy of this procedure are under review.

Conclusions:

  • There is an urgent need for alternative stroke prevention methods in AF patients with high bleeding risk.
  • Catheter-based left atrial appendage closure is a promising alternative.
  • Further research and randomized studies are crucial to solidify its role in AF management.