Left atrial appendage closure: An emerging option in atrial fibrillation when oral anticoagulants are not tolerated

David C. Peritz; Eugene H. Chung

doi:10.3949/ccjm.82a.14117

March 1, 2015Cleveland Clinic Journal of MedicineOpen Access

Left atrial appendage closure: An emerging option in atrial fibrillation when oral anticoagulants are not tolerated

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Why the study?

Does surgical and percutaneous isolation of the left atrial appendage reduce stroke risk in patients with atrial fibrillation who have contraindications to oral anticoagulation?

Structured PICO

Does surgical and percutaneous isolation of the left atrial appendage reduce stroke risk in patients with atrial fibrillation who have contraindications to oral anticoagulation?

P

Population

Patients with atrial fibrillation who have contraindications to oral anticoagulation

I

Intervention

Surgical and percutaneous isolation of the left atrial appendage

This review appraises the literature on surgical and percutaneous left atrial appendage closure for stroke prevention in atrial fibrillation patients with contraindications to oral anticoagulation.

Implication

Evidence for LAA closure in OAC-contraindicated AF remains limited; leaves open need for prospective trials.

Abstract

Atrial fibrillation is associated with a risk of stroke, primarily from embolization of clots that form in the left atrial appendage. This structure has been targeted to reduce stroke risk in patients who have contraindications to oral anticoagulation. This article appraises the current literature describing surgical and percutaneous isolation of the left atrial appendage.