Key result
Left atrial appendage occlusion using percutaneous transcatheter devices may be an alternative to vitamin K antagonist therapy for stroke prevention in selected patients with nonvalvular AF.
Why the study?
Do left atrial appendage-occluding devices prevent stroke in patients with nonvalvular atrial fibrillation compared to vitamin K antagonist therapy?
Do left atrial appendage-occluding devices prevent stroke in patients with nonvalvular atrial fibrillation compared to vitamin K antagonist therapy?
Left atrial appendage occlusion devices present a promising alternative to vitamin K antagonists for stroke prevention in selected patients with nonvalvular atrial fibrillation.
May support LAAO consideration in selected nonvalvular AF; leaves open need for randomized confirmation versus VKA.
Atrial fibrillation is associated with a fivefold increased risk for stroke, mostly secondary to thromboembolic events. Anticoagulation with a vitamin K antagonist is the standard medical therapy for these patients but is difficult to maintain within the therapeutic range and requires frequent monitoring and dose adjustments. Approximately 90% of thromboembolism occurs in the left atrial appendage (LAA) in patients with nonvalvular atrial fibrillation. Occlusion of flow into the LAA may prevent thrombus formation in the appendage and, hence, reduction of stroke. Recently, several percutaneous transcatheter techniques of LAA exclusion using the Percutaneous Left Atrial Appendage Transcatheter Occlusion device, the WATCHMAN device, and AMPLATZER septal occluder and cardiac plug have been employed, with encouraging results. Occlusion of the LAA may be an alternative to vitamin K antagonist therapy for selected patients.
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Yan et al. (2009) conducted a review in Nonvalvular atrial fibrillation. Left atrial appendage-occluding devices vs. Vitamin K antagonist was evaluated. Left atrial appendage occlusion using percutaneous transcatheter devices may be an alternative to vitamin K antagonist therapy for stroke prevention in selected patients with nonvalvular AF.
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