To occlude or not? Left atrial appendage occlusion for stroke prevention in atrial fibrillation

The cornerstone of atrial fibrillation (AF) management is effective stroke prevention, which by now remains the only proven method of improved survival in patients with AF. Oral anticoagulation with the use of vitamin K antagonists (eg, warfarin) or non-vitamin K antagonist oral anticoagulants (NOACs) has been shown to substantially reduce the risk of AF-related strokes and thus is presently the standard of care for stroke prevention in non-valvular AF. Approximately 90% of thrombi being formed in AF are localised in left atrial appendage (LAA).1 Thus, LAA exclusion seems a tempting method of prophylaxis against stroke, particularly if antithrombotic therapy could be utterly omitted to eliminate the risk of bleeding complications. Though the history of LAA occlusion dates back many years, it is more recent rapid developments and implementation of various percutaneous approaches to LAA closure. What is the evidence for LAA closure? There have been two...
Source: Heart - Category: Cardiology Authors: Tags: Drugs: cardiovascular system, Epidemiology Editorials Source Type: research