Update on left atrial appendage closure for neurologists.

Area of Science:

• Cardiology
• Neurology
• Medical Devices

Background:

• Many atrial fibrillation (AF) patients requiring thromboembolic protection are undertreated with oral anticoagulation (OAC).
• Direct oral anticoagulants (DOACs) offer improved safety over vitamin K antagonists but haven't resolved undertreatment.
• Reasons for OAC discontinuation include bleeding, adherence issues, or drug aversion.

Purpose of the Study:

• To provide an updated perspective on left atrial appendage closure (LAAC) for neurologists and stroke physicians.
• To summarize current evidence on indications, benefits, complications, and limitations of LAAC.
• To guide clinicians in considering LAAC as an alternative to OAC.

Main Methods:

• Review of current evidence on percutaneous LAAC.
• Focus on procedural safety improvements and clinical outcomes.
• Guideline-based perspective on LAAC indications and limitations.

Main Results:

• LAAC has demonstrated significant improvements in procedural safety.
• LAAC is increasingly favored for thromboembolic prevention in specific AF patient groups.
• LAAC serves as a viable alternative for patients unsuitable for or intolerant to OAC.

Conclusions:

• LAAC is a crucial therapeutic option for AF patients with contraindications or high risk with OAC.
• Neurologists and stroke physicians should be aware of LAAC's role in stroke prevention.
• Continued evaluation of LAAC evidence is essential for optimal patient management.