Key result
Left atrial appendage closure is a feasible alternative to pharmacologic intervention for preventing thromboembolic events and minimizing bleeding risk in patients with atrial fibrillation.
Why the study?
Oral anticoagulation reduces thromboembolic risk in AF but increases bleeding risk, motivating the review of left atrial appendage closure as an alternative mechanical intervention.
Does left atrial appendage closure (LAAC) reduce thromboembolic events and bleeding risk compared to oral anticoagulation in patients with atrial fibrillation?
Does left atrial appendage closure (LAAC) reduce thromboembolic events and bleeding risk compared to oral anticoagulation in patients with atrial fibrillation?
This narrative review highlights the evolution and current evidence for transcatheter left atrial appendage closure as an alternative to oral anticoagulation for stroke prevention in atrial fibrillation.
Answers are grounded in this paper and cite their sources.
Supports LAAC consideration in select AF patients unsuitable for OAC; extends narrative evidence while leaving definitive practice change open to further RCTs.
Atrial fibrillation (AF) is the most common cardiac arrhythmia and the cause of thromboembolic events in elderly patients worldwide. AF is associated with a significantly increased risk of morbidity and mortality due to cardiac emboli, primarily from left atrial appendage (LAA) thrombus. Oral anticoagulation therapy is the standard treatment to effectively reduce the risk of thromboembolic events in patients with AF. However, anticoagulation treatment increases bleeding risk. LAA closure (LAAC) has recently been introduced as a feasible mechanical preventive intervention for thromboembolic events while minimizing the risk of bleeding. Transcatheter LAAC devices have evolved in the past decade, and several ongoing trials have demonstrated the improvements of safety and outcomes in newer generation devices. This review summarizes the current perspectives and outcomes regarding LAAC as an alternative to pharmacologic therapy.
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Nagasaka et al. (2023) conducted a review in Atrial fibrillation. Left atrial appendage closure (LAAC) vs. Oral anticoagulation therapy was evaluated. Left atrial appendage closure is a feasible alternative to pharmacologic intervention for preventing thromboembolic events and minimizing bleeding risk in patients with atrial fibrillation.
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