Advances in the Management of Atrial Fibrillation with a Special Focus on Non-Pharmacological Approaches to Prevent Thromboembolism: A Review of Current Recommendations

Q: What is the clinical evidence from this study?

Study design: Review. Population: Atrial fibrillation. Intervention: Surgical and percutaneous exclusion or occlusion of the left atrial appendage vs. Anticoagulation. Primary outcome: Thromboembolic complications.

Malini Riddle; Richard W. McCallum; Chandra Ojha; Timir K. Paul; Vineet Gupta; David A. Baran; Bharat Prakash; Amogh Misra; Adriana Mares; Moeen Abedin; Archana Kedar; Venkatachalam Mulukutla; Ahmed Ibrahim; Harsha S. Nagarajarao

doi:10.1136/jim-2020-001500

November 17, 2020Journal of Investigative Medicine

Advances in the Management of Atrial Fibrillation with a Special Focus on Non-Pharmacological Approaches to Prevent Thromboembolism: A Review of Current Recommendations

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Why the study?

Anticoagulation for thromboembolism prevention in AFIB carries bleeding risks, prompting the evolution of surgical and percutaneous left atrial appendage exclusion or occlusion options.

Do non-pharmacological approaches such as surgical or percutaneous left atrial appendage occlusion prevent thromboembolic complications in patients with atrial fibrillation?

Structured PICO

Do non-pharmacological approaches such as surgical or percutaneous left atrial appendage occlusion prevent thromboembolic complications in patients with atrial fibrillation?

P

Population

Patients with atrial fibrillation (AFIB)

I

Intervention

Non-pharmacological approaches to prevent thromboembolism, specifically surgical or percutaneous exclusion or occlusion of the left atrial appendage

O

Outcome

Prevention of thromboembolic complications

Implication

This review highlights the evolving role of non-pharmacological interventions, such as surgical and percutaneous left atrial appendage occlusion, as alternatives to anticoagulation for preventing thromboembolism in atrial fibrillation.

Abstract

Atrial fibrillation (AFIB) is the most common heart rhythm abnormality and is associated with significant morbidity and mortality. While the treatment of AFIB involves strategies of rate with or without rhythm control, it is also essential to strategize appropriate therapies to prevent thromboembolic complications arising from AFIB. Previously, anticoagulation was the main treatment option which exposed patients to higher than usual risk of bleeding. However, with the advent of new technology, novel therapeutic options aimed at surgical or percutaneous exclusion or occlusion of the left atrial appendage in preventing thromboembolic complications from AFIB have evolved. This review evaluates recent advances and therapeutic options in treating AFIB with a special focus on both surgical and percutaneous interventions which can reduce and/or eliminate thromboembolic complications of AFIB.

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Cite This Study

Riddle et al. (2020) conducted a review in Atrial fibrillation. Surgical and percutaneous exclusion or occlusion of the left atrial appendage vs. Anticoagulation was evaluated on Thromboembolic complications.

synapsesocial.com/papers/6a0ed6c02eca052da647d556 https://doi.org/10.1136/jim-2020-001500