Mechanical antithrombotic intervention by LAA occlusion in atrial fibrillation

Yu, Cheuk-Man; Khattab, Ahmed Aziz; Bertog, Stefan C; Lee, Alex P W; Kwong, Joey S W; Sievert, Horst; Meier, Bernhard (2013). Mechanical antithrombotic intervention by LAA occlusion in atrial fibrillation. Nature reviews - cardiology, 10(12), pp. 707-722. Nature Publishing Group 10.1038/nrcardio.2013.158

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Stroke in patients with atrial fibrillation (AF) is often associated with substantial morbidity and mortality. Oral anticoagulation remains the first-line approach to stroke prevention in such individuals; however, for a considerable proportion of patients, traditional treatment using warfarin is limited by a number of factors, such as the inconvenience of frequent therapeutic monitoring and the risk of haemorrhage. The development of new oral anticoagulants with improved efficacy and safety profiles has provided viable options for oral anticoagulation therapy in patients with nonvalvular (nonrheumatic AF). Nonetheless, in patients who have an increased risk of major haemorrhage, a nonpharmacological approach to antithrombotic therapy remains an attractive alternative. The left atrial appendage (LAA) has been found to be the source of >90% of thrombi in patients with nonvalvular AF; thus, prevention of thrombus formation via transcatheter mechanical LAA occlusion is a novel therapeutic target for stroke prevention in this patient population. In this Review, we present the rationale for LAA occlusion in patients with AF, the available occlusion devices and their clinical evidence to date. We also discuss the roles of various imaging techniques in device implantation and the management strategy for associated procedural complications.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Khattab, Ahmed Aziz and Meier, Bernhard

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1759-5010

Publisher:

Nature Publishing Group

Language:

English

Submitter:

Daria Vogelsang

Date Deposited:

24 Mar 2014 10:08

Last Modified:

09 Mar 2016 15:32

Publisher DOI:

10.1038/nrcardio.2013.158

PubMed ID:

24145892

URI:

https://boris.unibe.ch/id/eprint/44967

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