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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

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[Atrial appendage occlusion in the prevention of ischemic stroke: a systematic review and meta-analysis]

Paul E Hernández-Montes1,2, Eliseo Añorve-García2,3, César J Guitrón-Ramírez2,4

  • 1Departamento de Medicina General, Centro de Salud Juan Escutia, Tepic, Nayarit, México.

Archivos De Cardiologia De Mexico
|November 4, 2025
PubMed

Insights

Percutaneous left atrial appendage occlusion (LAAO) shows promise for reducing all-cause mortality in atrial fibrillation (AF) patients. While not significantly reducing ischemic stroke, LAAO offers an alternative when anticoagulation is challenging.

Area of Science:

  • Cardiology
  • Medical Devices
  • Preventive Medicine

Background:

  • Atrial fibrillation (AF) increases stroke risk.
  • Anticoagulation is standard but has limitations.
  • Left atrial appendage occlusion (LAAO) is an alternative therapy.

Purpose of the Study:

  • To compare percutaneous LAAO efficacy against anticoagulation.
  • To assess LAAO's impact on ischemic stroke and mortality in high-risk AF patients.

Main Methods:

  • Systematic review of 10 studies (5,779 patients).
  • Searched PubMed, Scopus, Web of Science.
  • Assessed risk of bias using RoB 2 and ROBINS-E.

Main Results:

  • LAAO showed a non-significant trend in reducing ischemic stroke (OR: 0.82; p=0.09).
  • LAAO significantly reduced all-cause mortality (OR: 0.62; p=0.0004).
  • Compared favorably to DOACs and VKAs.

Conclusions:

  • LAAO is a viable strategy to reduce mortality in AF patients.
  • It's particularly useful when long-term anticoagulation is not feasible.
  • LAAO may improve adherence and quality of life.

Keywords:
AnticoagulationAtrial fibrillationIsquemic strokeLeft atrial appendage occlusionSystematic review

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