Key result
LAAO and excision provide alternative thromboembolism prophylaxis in AF patients with anticoagulant contraindications.
Why the study?
Anticoagulants to reduce left atrial appendage thrombus formation may be contraindicated in some AF patients, prompting the need for alternative thromboembolism prophylaxis treatments such as left atrial appendage occlusion or excision.
This contemporary review summarizes the role of the left atrial appendage in thrombus formation and the clinical utility of its occlusion or excision for thromboembolism prophylaxis in atrial fibrillation.
May offer an option for anticoagulant-ineligible AF patients; leaves open need for randomized confirmation of long-term efficacy.
In patients with atrial fibrillation, the left atrial appendage may serve as the site of thrombus formation due to stasis that occurs within the appendage because of its shape and trabeculations. Although thrombus formation can be reduced with anticoagulants, this may be contraindicated in some patients. The need for a better alternative treatment prompted study of left atrial appendage occlusion for thromboembolism prophylaxis. Due to this, procedures that excise or occlude the left atrial appendage have gained attention because of its ability to prevent thromboembolic events. This article provides a comprehensive review of the left atrial appendage and its associated procedures' clinical utility.
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Sulague et al. (2023) conducted a review in Atrial fibrillation. Left atrial appendage occlusion or excision was evaluated. Left atrial appendage occlusion and excision procedures provide an alternative for thromboembolism prophylaxis in patients with atrial fibrillation who have contraindications to anticoagulants.
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