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April 30, 2014Arrhythmia & Electrophysiology ReviewOpen Access

Left Atrial Appendage Closure Devices For Stroke Prevention

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Key result

Left atrial appendage closure devices provide a promising non-pharmacological alternative to systemic anticoagulation for stroke prevention in patients with atrial fibrillation.

Why the study?

Do catheter-based left atrial appendage occlusion devices prevent thromboembolic stroke in patients with atrial fibrillation compared to systemic anticoagulation or antiplatelet therapy?

Population

Patients with atrial fibrillation at risk of cardioembolic stroke, including those with and without…

Comparison

Endovascular and epicardial catheter-based left… vs Systemic anticoagulation or antiplatelet…

Design

Review

Authors

SKSunil KapurMMMoussa Mansour

Discussion

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Overview

May support LAA closure in anticoagulation-intolerant AF patients; leaves open need for definitive RCTs versus NOACs.

Structured PICO

Do catheter-based left atrial appendage occlusion devices prevent thromboembolic stroke in patients with atrial fibrillation compared to systemic anticoagulation or antiplatelet therapy?

P
Population
Patients with atrial fibrillation at risk of thromboembolic stroke, including those with and without contraindications to systemic anticoagulation.
I
Intervention
Endovascular and epicardial catheter-based left atrial appendage (LAA) occlusion devices (including PLAATO, WATCHMAN, Amplatzer Cardiac Plug, LARIAT, and Aegis).
C
Comparator
Systemic anticoagulation (e.g., warfarin) or antiplatelet therapy/no therapy (in patients with contraindications to anticoagulation).
O
Outcome
Reduction in the risk of thromboembolic stroke.

Catheter-based LAA occlusion devices represent a promising, non-pharmacological alternative for stroke prevention in patients with atrial fibrillation, particularly those with contraindications to long-term anticoagulation.

Limitations

  • Incomplete left atrial appendage closure with residual peri-device flow
  • Procedural complications such as cardiac tamponade, pericardial effusion, and device embolization
  • Need for peri-procedural anticoagulation with some devices

Cite This Study

Kapur et al. (2014) conducted a review in Atrial fibrillation. Left atrial appendage closure devices vs. Systemic anticoagulation was evaluated. Left atrial appendage closure devices provide a promising non-pharmacological alternative to systemic anticoagulation for stroke prevention in patients with atrial fibrillation.

synapsesocial.com/papers/6a7b60eee357fbdac589d94chttps://doi.org/10.15420/aer.2011.3.1.25
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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 with Amplatzer cardiac plug for stroke prevention in atrial fibrillation: Initial Asia‐Pacific experience2011 · 163 citations
  2. 2Thrombus formation after left atrial appendage exclusion using an amplatzer cardiac plug device2011 · 51 citations
  3. 3Occluding the left atrial appendage: anatomical considerations2007 · 169 citations
  4. 4Echocardiographic assessment of the left atrial appendage1999 · 301 citations
  5. 5Band Occlusion of the Atrial Appendage2010 · 6 citations