Transcatheter Left Atrial Appendage Occlusion - 07/08/13

Doi : 10.1016/j.ccl.2013.05.008

Creighton W. Don, MD, PhD ^a, Cindy J. Fuller, PhD ^b, Mark Reisman, MD ^b,^⁎
^a Department of General Internal Medicine, Division of Cardiology, University of Washington Medical Center, 1959 Northeast Pacific Street, Seattle, WA 98195, USA
^b Swedish Heart & Vascular Institute, Swedish Medical Center, University of Washington Medical Center, 1959 Northeast Pacific Street, Box 356422, Seattle, WA 98195, USA

^∗Corresponding author.

Résumé

Occlusion of the left atrial appendage (LAA) may reduce the risk of stroke in patients with atrial fibrillation (AF). Trials comparing LAA occlusion to warfarin anticoagulation in patients with nonvalvular AF showed a reduction in hemorrhagic stroke, although an increase in safety events due to procedural complications. Long-term follow-up suggests possible superiority of LAA occlusion due to fewer strokes and bleeding events. The superior dosing and safety profiles of the novel oral anticoagulants raise the accepted threshold for safety and efficacy of LAA occlusion procedures, and underscore the need for randomized studies comparing LAA occlusion with these newer anticoagulants.

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Keywords : Transcatheter, Left atrial appendage, Occlusion, Atrial fibrillation

Plan

	Portions of this article were published previously in Fuller CJ, and Reisman M. Stroke prevention in atrial fibrillation: atrial appendage closure. Current Cardiology Reports 2011;13:159–166; with kind permission from Springer Science+Business Media B.V.
	Funding: This publication was made possible by grant number KL2 RR025015 from the National Center for Research Resources (NCRR).
	Disclosures: No conflicts of interest exist.