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January 1, 2023International Journal of ArrhythmiaOpen Access

Left atrial appendage closure, including recent surgical and percutaneous devices, provides a feasible treatment alternative for stroke prevention in non-valvular atrial fibrillation patients with contraindications to oral anticoagulants.

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Why the study?

Stroke prevention is paramount in AF, but patients unable to tolerate oral anticoagulants require alternative non-pharmacological approaches such as percutaneous or surgical LAA closure.

Design

Review

Key result

Left atrial appendage closure, including recent surgical and percutaneous devices, provides a feasible treatment alternative for stroke prevention in non-valvular atrial fibrillation patients with contraindications to oral anticoagulants.

Authors

DJDong Seop Jeong

Discussion

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Overview

May support LAA strategies in anticoagulant-intolerant AF; hypothesis-generating and requires prospective validation before practice change.

Structured PICO

P
Population
Patients with non-valvular atrial fibrillation who experience NOAC failure or have a high bleeding risk with oral anticoagulants
I
Intervention
Left atrial appendage closure (percutaneous methods like AMPLATZER Amulet and WATCHMAN, or surgical methods like thoracoscopic clip devices)

Surgical LAAC via thoracoscopy is emerging as a feasible, less invasive alternative to percutaneous LAAC for stroke prevention in non-valvular AF patients with NOAC failure or high bleeding risk.

Limitations

  • Lack of sufficient research on the long-term outcomes of epicardial devices
  • Lack of clear comparative research between AtriClip and anticoagulant therapy
  • Potential impacts on cardiac hormones and residual LAA function require further investigation

Cite This Study

Dong Seop Jeong (2023) conducted a review in Atrial fibrillation. Left atrial appendage closure vs. Oral anticoagulants was evaluated. Left atrial appendage closure, including recent surgical and percutaneous devices, provides a feasible treatment alternative for stroke prevention in non-valvular atrial fibrillation patients with contraindications to oral anticoagulants.

synapsesocial.com/papers/6aa045ee9b026715997e28f9https://doi.org/10.1186/s42444-023-00103-4
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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: A new technique for clinical practice2013 · 35 citations
  2. 2Utilization of percutaneous left atrial appendage closure in patients with atrial fibrillation: an update on patient outcomes2020 · 6 citations
  3. 3Percutaneous Left Atrial Appendage Occlusion: An Emerging Option in Patients with Atrial Fibrillation at High Risk of Bleeding2021 · 14 citations
  4. 4The Left Atrial Appendage: Target for Stroke Reduction in Atrial Fibrillation2015 · 36 citations
  5. 5Left Atrial Appendage Closure Devices for Stroke Prevention in Patients with Non-Valvular AF2018 · 1 citations