Key result
Percutaneous left atrial appendage closure may serve as a beneficial alternative to oral anticoagulation for stroke prevention in non-valvular atrial fibrillation patients with specific hemorrhagic diseases, end-stage renal disease, or low compliance.
Why the study?
Guidelines recommend percutaneous LAAC for NVAF patients at high thromboembolic risk with contraindications to OAC, but other clinical situations may also benefit from the procedure.
Does percutaneous left atrial appendage closure provide benefit in patients with non-valvular atrial fibrillation and non-classic indications?
Does percutaneous left atrial appendage closure provide benefit in patients with non-valvular atrial fibrillation and non-classic indications?
Percutaneous left atrial appendage closure may have a beneficial role in stroke prevention for NVAF patients beyond classic guideline indications, such as those with specific hemorrhagic diseases, ESRD, or low OAC compliance.
May warrant consideration in select high-bleeding-risk patients; leaves open need for randomized confirmation.
Percutaneous left atrial appendage closure (LAAC) has proven to be an effective alternative to oral anticoagulation (OAC) for stroke prevention in patients with non-valvular atrial fibrillation (NVAF). International guidelines traditionally recommend LAAC for NVAF patients at high thromboembolic risk and contraindication to or at high risk for OAC. However, there are many other clinical situations in which this procedure may also be beneficial. This paper discusses the potential role of LAAC in specific haemorrhagic diseases (cerebral amyloid angiopathy, age-related macular degeneration, hereditary haemorrhagic telangiectasia, and Moyamoya disease), after left atrial appendage (LAA) electrical isolation, in cases of persistent thrombus inside the LAA, in end-stage renal disease and in special groups of patients for whom low compliance and persistence to OAC may be anticipated.
No takes yet. Share an insight, caveat, or question.
Guérios et al. (2023) conducted a review in Non-valvular atrial fibrillation. Percutaneous left atrial appendage closure (LAAC) vs. Oral anticoagulation (OAC) was evaluated. Percutaneous left atrial appendage closure may serve as a beneficial alternative to oral anticoagulation for stroke prevention in non-valvular atrial fibrillation patients with specific hemorrhagic diseases, end-stage renal disease, or low compliance.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: