2025年SCAI/HRS临床实践指南关于通过导管的左心房尾闭塞
Andrew M Goldsweig1, Michael Glikson2, Jacqueline Joza3
1Department of Cardiovascular Medicine, Baystate Medical Center and Division of Cardiovascular Medicine, University of Massachusetts-Baystate, Springfield, Massachusetts.
Heart rhythm
|August 4, 2025
概括
左心房尾阻塞 (LAAO) 装置可降低心房患者中风风险. 这些指导方针涉及LAAO的最佳实践,包括患者选择和管理诸如周围设备泄漏等并发症.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 电子生理学 电子生理学
背景情况:
- 左心房尾阻塞 (LAAO) 装置为心房患者提供中风风险降低,与没有抗凝药相比.
- 关于最佳的患者选择,成像,抗血栓治疗和周围设备泄漏 (PDL) 和设备相关血栓 (DRT) 的管理,存在持续的不确定性.
研究的目的:
- 为左心室尾闭塞 (LAAO) 程序提供基于证据的指导方针.
- 解决实践变化,并支持LAAO管理中的临床决策.
主要方法:
- 一个多学科的指导小组召开了会议,使用了推评估,开发和评估 (GRADE) 的分级方法.
- 专家技术审查小组对已发表的证据进行了系统审查.
- 使用GRADE证据决策框架制定了建议.
主要成果:
- 制定了八项基于证据的建议,以规范LAAO程序的护理.
- 确定了关于LAAO管理的两个重大知识缺口.
结论:
- 关键建议侧重于患者选择,周围手术成像,抗血栓策略以及管理PDL和DRT.
- 建议在LAAO和PDL后对单抗血小板治疗进行未来的研究.
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