Mechanical antithrombotic intervention by LAA occlusion in atrial fibrillation
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AbstractStroke in patients with atrial fibrillation (AF) is often associated with substantial morbidity and mortality. Oral anticoagulation remains the first-line approach to stroke prevention in such individuals; however, for a considerable proportion of patients, traditional treatment using warfarin is limited by a number of factors, such as the inconvenience of frequent therapeutic monitoring and the risk of haemorrhage. The development of new oral anticoagulants with improved efficacy and safety profiles has provided viable options for oral anticoagulation therapy in patients with nonvalvular (nonrheumatic AF). Nonetheless, in patients who have an increased risk of major haemorrhage, a nonpharmacological approach to antithrombotic therapy remains an attractive alternative. The left atrial appendage (LAA) has been found to be the source of >90% of thrombi in patients with nonvalvular AF; thus, prevention of thrombus formation via transcatheter mechanical LAA occlusion is a novel therapeutic target for stroke prevention in this patient population. In this Review, we present the rationale for LAA occlusion in patients with AF, the available occlusion devices and their clinical evidence to date. We also discuss the roles of various imaging techniques in device implantation and the management strategy for associated procedural complications. © 2013 Macmillan Publishers Limited.
All Author(s) ListYu C.-M., Khattab A.A., Bertog S.C., Lee A.P.W., Kwong J.S.W., Sievert H., Meier B.
Journal nameNature Reviews Cardiology
Year2013
Month10
Day24
Volume Number10
Issue Number12
PublisherNature Publishing Group
Place of PublicationUnited Kingdom
Pages707 - 722
ISSN1759-5002
eISSN1759-5010
LanguagesEnglish-United Kingdom

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