What question did this study set out to answer?

Determine the optimal antithrombotic strategy to prevent device-related thrombus formation without increasing bleeding risks following left atrial appendage closure.

December 1, 2014Expert Review of Cardiovascular Therapy

Antithrombotic therapy after left atrial appendage closure

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Why the study?

What is the optimal antithrombotic therapy strategy after left atrial appendage closure to prevent device thrombosis without increasing bleeding risk?

Key Points

Determine the optimal antithrombotic strategy to prevent device-related thrombus formation without increasing bleeding risks following left atrial appendage closure.
Evaluated post-implantation antithrombotic management across trial cohorts receiving vitamin K antagonists and real-world populations with contraindications to oral anticoagulation.
Examined clinical outcomes and evidence gaps regarding dual antiplatelet therapy regimens, treatment duration, direct anticoagulants, and long-term aspirin use.
Dual antiplatelet therapy provides an effective alternative antithrombotic strategy for patients unable to take oral anticoagulants due to major bleeding contraindications.
The optimal duration of post-implantation antithrombotic treatment and the necessity of continuing aspirin therapy over the long term remain unestablished.

Structured PICO

What is the optimal antithrombotic therapy strategy after left atrial appendage closure to prevent device thrombosis without increasing bleeding risk?

Population

Patients after successful interventional left atrial appendage closure

Intervention

Antithrombotic therapy (including vitamin K antagonists, dual antiplatelet therapy, direct oral anticoagulants, or aspirin)

Outcome

Prevention of on-device thrombus formation without increasing bleeding complications

This review highlights the clinical challenge of selecting optimal antithrombotic therapy post-LAAC, especially in patients with contraindications to oral anticoagulation, and identifies key areas for future research.

Discussion

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Implication

DAPT may warrant consideration post-LAAC when OAC is contraindicated; leaves optimal duration and DOAC role unresolved for prospective trials.

Cite This Study

Schmidt et al. (2014) studied this question.

synapsesocial.com/papers/6a87d1001fec1a0b3d26317a https://doi.org/10.1586/14779072.2015.988612

Topics

Left atrial appendage closure Atrial fibrillation Persistent AF management Anticoagulation in AF AF ablation outcomes

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Implication

DAPT may warrant consideration post-LAAC when OAC is contraindicated; leaves optimal duration and DOAC role unresolved for prospective trials.

Antithrombotic therapy after left atrial appendage closure

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Topics

Antithrombotic therapy after left atrial appendage closure

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider