Document Detail


An update and current expert opinions on percutaneous left atrial appendage occlusion for stroke prevention in atrial fibrillation.
MedLine Citation:
PMID:  23625943     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Oral anticoagulation (OAC) remains the mainstream therapy for ischaemic stroke prevention in patients with atrial fibrillation (AF). However, for patients contraindicated to OAC and those who experienced a stroke while on therapeutic OAC, no reasonable pharmacotherapy is available. Although surgical left atrial appendage (LAA) excision offers a non-pharmacological alternative, effective stroke prevention by this treatment is not demonstrated by randomized clinical studies. Percutaneous occlusion of the LAA may be an alternative therapy for selected AF patients. Recently reported results confirm the technical feasibility of this technique and its effectiveness in preventing ischaemic stroke. With increasing operator experience, successful and event-free device implantation is achieved in typically 97% of the cases. Moreover, in non-randomized cohorts implanted with LAA occlusion devices, stroke rates are markedly reduced compared with rates predicted by risk stratification schemes such as CHADS2 and CHA2DS2-VASc. This paper summarizes recently published results from clinical studies on percutaneous LAA occlusion and current expert opinions with respect to patients who may be suitable for this therapy. In addition, several aspects regarding the safety of device implantation for LAA occlusion and follow-up of patients are discussed.
Authors:
Thorsten Lewalter; Réda Ibrahim; Bert Albers; A John Camm
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology     Volume:  15     ISSN:  1532-2092     ISO Abbreviation:  Europace     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-04-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883649     Medline TA:  Europace     Country:  England    
Other Details:
Languages:  eng     Pagination:  652-6     Citation Subset:  IM    
Affiliation:
Isar Heart Center Munich, Munich, Germany.
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