Stroke prevention in atrial fibrillation with left atrial appendage closure.

Journal Article (Review)

Patients with atrial fibrillation (AF) are at risk for stroke and thromboembolism. Oral anticoagulants (OAC) are effective therapies to reduce the risk of stroke; however, these agents also increase the risk of bleeding complications. Concerns over bleeding contribute to significant under treatment and leave a substantial proportion of patients at risk for a serious or life-threatening stroke. Identification of the left atrial appendage (LAA) as the major site of pathogenic thrombus formation in AF patients has led to the development of devices which exclude the appendage from the systemic circulation. These devices offer a potential alternative treatment for some AF patients who cannot tolerate long term OAC. This article will review the pathogenesis of LAA thrombus formation and identify the patient population most likely to benefit from LAA closure devices. Finally, we will review LAA closure techniques (both surgical and percutaneous), evaluate published outcomes data, and discuss the indications and risk/benefit considerations of each approach.

Full Text

Cited Authors

  • Zack, CJ; Fender, EA; Holmes, DR

Published Date

  • June 2017

Published In

Volume / Issue

  • 108 / 3

Start / End Page

  • 199 - 211

PubMed ID

  • 28001014

Electronic International Standard Serial Number (EISSN)

  • 1827-1669

International Standard Serial Number (ISSN)

  • 0026-4806

Digital Object Identifier (DOI)

  • 10.23736/s0026-4806.16.04981-8

Language

  • eng