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Updated: Oct 6, 2025
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
2019 Chinese expert consensus statement on left atrial appendage closure in patients with atrial fibrillation
He Ben1, Ma Changsheng2, Wu Shulin3
1Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China.
Insights
Left atrial appendage closure (LAAC) effectively prevents stroke in atrial fibrillation patients. This expert consensus provides comprehensive guidance on LAAC device selection, management, and complication handling for optimal clinical application.
Area of Science:
- Cardiology
- Medical Devices
- Stroke Prevention
Background:
- Left atrial appendage closure (LAAC) is recommended for stroke prevention in high-risk non-valvular atrial fibrillation (NVAF) patients.
- Existing guidelines lack comprehensive recommendations on LAAC devices, imaging, complication management, and perioperative care.
- LAAC is an emerging technology requiring standardized clinical application guidelines.
Purpose of the Study:
- To issue an expert consensus statement on the clinical application of LAAC for stroke prevention in atrial fibrillation patients.
- To provide comprehensive recommendations covering devices, imaging, complications, and perioperative management for LAAC.
- To standardize LAAC procedures based on existing evidence and clinical experience.
Main Methods:
- A consensus statement was jointly issued by the Chinese Society of Cardiology (CSC) and the Chinese Journal of Cardiology.
- Experts from diverse backgrounds engaged in comprehensive discussions to formulate recommendations.
- Recommendations are categorized into three levels: appropriate, uncertain, and inappropriate, based on evidence and clinical practice.
Main Results:
- The consensus provides tiered recommendations (appropriate, uncertain, inappropriate) for LAAC application.
- Guidance is offered on device selection, imaging modalities, complication identification and treatment, perioperative medication, and postoperative management.
- The recommendations aim to guide and standardize the clinical use of LAAC.
Conclusions:
- This expert consensus provides crucial guidance for the safe and effective clinical application of LAAC in stroke prevention for atrial fibrillation patients.
- The tiered recommendation system addresses the need for comprehensive, evidence-based standards in this emerging field.
- Standardized application of LAAC, guided by this consensus, is expected to improve patient outcomes.
Abstract:
The left atrial appendage closure (LAAC), the efficacy and safety of which has been proved by a number of randomized controlled trials and registries, is recommended by several guidelines to prevent stroke in high-risk patients with non-valvular atrial fibrillation. However, current guidelines only discuss the indications and contraindications of LAAC, as an emerging technology, there still lacks comprehensive recommendations involved with LAAC, including devices, image assessment modality, identification and treatment of complications, perioperative medication, and postoperative management. Therefore, the Chinese Society of Cardiology (CSC) of Chinese Medical Association (CMA) and the Editorial Board of Chinese Journal of Cardiology jointly issued the expert consensus statement on LAAC in the prevention of stroke in patients with atrial fibrillation after comprehensive discussion by experts with different backgrounds. This consensus provided three levels of recommendations to guide and standardize the clinical application of LAAC based on existing evidence and clinical practice experience, including appropriate (more potential benefits or fewer harms), uncertain (somehow reasonable but need more evidence), and inappropriate (unlikely to benefit, or have more complications).
