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November 8, 2023Cardiology and TherapyOpen Access

Left Atrial Appendage Closure: A Narrative Review

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Key result

LAAC offers a feasible alternative to anticoagulation for preventing thromboembolism and minimizing bleeding in AF.

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?

Comparison

LAAC vs pharmacologic therapy

Design

Narrative review

Authors

TNTakashi NagasakaMNMamoo Nakamura

Discussion

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Overview

Supports LAAC consideration in select AF patients unsuitable for OAC; extends narrative evidence while leaving definitive practice change open to further RCTs.

Structured PICO

Does left atrial appendage closure (LAAC) reduce thromboembolic events and bleeding risk compared to oral anticoagulation in patients with atrial fibrillation?

P
Population
Patients with atrial fibrillation
I
Intervention
Left atrial appendage closure (LAAC)
C
Comparator
Oral anticoagulation therapy
O
Outcome
Thromboembolic events and bleeding risk

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.

Limitations

  • Clinical outcome data for LAAC is currently limited
  • Evidence supporting reduced-dose anticoagulant regimens after LAAC is currently limited

Cite This Study

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.

synapsesocial.com/papers/6a0848251e8b9db648ddfd63https://doi.org/10.1007/s40119-023-00337-2
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Left Atrial Appendage Closure Devices2014 · 25 citations
  2. 2Left atrial appendage closure for thromboembolism prevention in patients with atrial fibrillation: advances and perspectives.2015 · 25 citations
  3. 3Management of left atrial appendage thrombus before percutaneous closure: Case report2025 · 2 citations
  4. 4Left Atrial Appendage Closure in Atrial Fibrillation: A World without Anticoagulation?2011 · 24 citations
  5. 5Left Atrial Appendage Closure Devices For Stroke Prevention2014 · 7 citations