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An update and current expert opinions on percutaneous left atrial appendage occlusion for stroke prevention in atrial fibrillation
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...
Source: Europace - April 26, 2013 Category: Cardiology Authors: Lewalter, T., Ibrahim, R., Albers, B., Camm, A. J. Tags: REVIEW Source Type: research

Does atrial fibrillation ablation really reduce stroke rates?
Atrial fibrillation (AF) is increasingly becoming common among older people, and its prevalence is around 1% of the adult population in North America (roughly 2.2 million people). Patients with AF have an increased risk of strokes, heart failure, and subsequent mortality. Although antiarrhythmic drugs for restoring sinus rhythm have failed to reduce these risks, a subanalysis showed that achieving sinus rhythm was associated with halving the mortality but this effect was negated if antiarrhythmic therapy was continued. In fact, the ATHENA (A placebo-controlled, double-blind, parallel-arm Trial to assess the efficacy of dro...
Source: Heart Rhythm - July 22, 2013 Category: Cardiology Authors: Yasuo Okumura Tags: Editorial Commentary Source Type: research

Percutaneous closure of left atrial appendage for stroke prevention
In conclusion, we need more data and more studies to prove the LAAC principle specifically in the new era of direct oral anticoagulation therapy.
Source: Cor et Vasa - March 18, 2016 Category: Cardiology Source Type: research

Preserved Left Atrial Function Following Left Atrial Appendage Closure for Stroke Prevention.
CONCLUSION: LA function is crucial for cardiovascular function and recurrence of AF. Our study provides evidence that LA appendage closure preserves LA function, determined by strain imaging in patients with paroxysmal AF and sinus rhythm during echocardiography. PMID: 33385985 [PubMed - as supplied by publisher]
Source: The Journal of Invasive Cardiology - January 3, 2021 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Left atrial appendage closure for stroke prevention in nonvalvular atrial fibrillation: A current overview
J Cardiol. 2022 Nov 15:S0914-5087(22)00277-5. doi: 10.1016/j.jjcc.2022.11.006. Online ahead of print.ABSTRACTAtrial fibrillation (AF) is the most common arrhythmia encountered in clinical practice and its prevalence increases with age. AF causes palpitations, heart failure, and cardiogenic embolism. Of them, the most critical and fatal complication is a cardio-embolic event. Oral anticoagulation plays a central role in reducing stroke risk in AF patients. Recently, when oral anticoagulation is considered in patients with non-valvular AF who are eligible for direct oral coagulations, they are preferred to vitamin K antagoni...
Source: Journal of Cardiology - November 18, 2022 Category: Cardiology Authors: Hiroshi Ueno Teruhiko Imamura Shuhei Tanaka Nobuyuki Fukuda Koichiro Kinugawa Source Type: research

Left Atrial Appendage Closure Under Intracardiac Echocardiographic Guidance: Feasibility and Comparison With Transesophageal Echocardiography Interventional Cardiology
ConclusionsTranscatheter left atrial appendage closure with intracardiac echocardiography guidance is safe and feasible.
Source: JAHA:Journal of the American Heart Association - September 27, 2016 Category: Cardiology Authors: Matsuo, Y., Neuzil, P., Petru, J., Chovanec, M., Janotka, M., Choudry, S., Skoda, J., Sediva, L., Kurabayashi, M., Reddy, V. Y. Tags: Atrial Fibrillation, Imaging, Ischemic Stroke, Thrombosis Original Research Source Type: research

Safety and efficacy of transcatheter left atrial appendage closure using the Watchman device in Egyptian patients with nonvalvular atrial fibrillation
Conclusion LAA closure with the Watchman device can be safely performed, and may be a reasonable alternative to consider for patients at high risk for stroke but with contraindications to systemic oral anticoagulation or with high risk of bleeding.
Source: The Egyptian Heart Journal - July 18, 2015 Category: Cardiology Source Type: research

Left Atrial Appendage Closure With the Watchman™ Device
Conclusions Left atrial appendage closure with the WatchmanTM device is feasible and may be a good alternative therapy for stroke prevention in patients with atrial fibrillation and restrictions for anticoagulation.
Source: Revista Brasileira de Cardiologia Invasiva - November 26, 2014 Category: Cardiology Source Type: research

Kidney function stratified outcomes of percutaneous left atrial appendage occlusion in patients with atrial fibrillation and high bleeding risk.
CONCLUSIONS: Left atrial appendage occlusion shows comparable efficacy for stroke and bleeding prevention in CKD and Non-CKD patients. CKD patients experience more adverse events during follow-up and a significantly increased risk for periprocedural contrast-induced acute kidney injury. PMID: 30983505 [PubMed - as supplied by publisher]
Source: Acta Cardiologica - April 16, 2019 Category: Cardiology Tags: Acta Cardiol Source Type: research

Lipid-Lowering Agents
The role of lipid lowering in reducing the risk of mortality and morbidity from cardiovascular disease (CVD) is well established. Treatment particularly aimed at decreasing low-density lipoprotein cholesterol (LDL-C) is effective in reducing the risk of death from coronary heart disease and stroke. Statins form the cornerstone of treatment. However, in some individuals with a high risk of CVD who are unable to achieve their target LDL-C due to either intolerance or lack of efficacy, there is the need for alternative therapies. This review provides an overview of the different classes of currently available lipid-lowering m...
Source: Journal of Cardiovascular Pharmacology and Therapeutics - August 12, 2013 Category: Cardiology Authors: Ewang-Emukowhate, M., Wierzbicki, A. S. Tags: Cardiovascular Pharmacology Core Review Source Type: research

The Week Ahead: Stroke Meeting, MedPage Todayon 'Precision Medicine'
(MedPage Today) -- Washington turns focus on vaccines, mental health, and complementary medicine.
Source: MedPage Today Cardiovascular - February 8, 2015 Category: Cardiology Source Type: news

Resolution (and Late Recurrence) of WATCHMAN Device–Related Thrombus Following Treatment with Dabigatran
The WATCHMAN left atrial (LA) appendage closure system is an alternative therapy for stroke prevention in patients with atrial fibrillation who are intolerant to chronic oral anticoagulation with warfarin. Infrequently, LA device–related thrombus (DRT) has been suspected. Optimal treatment of DRT is not known, and the efficacy of novel oral anticoagulants (NOAC) in this setting has not been previously described. A 69‐year‐old woman with permanent atrial fibrillation underwent WATCHMAN device placement. A transesophageal echocardiogram (TEE) performed 45 days following implant revealed a well‐seated device. A 1‐ye...
Source: Echocardiography - January 17, 2016 Category: Cardiology Authors: Abdul H. Qazi, Alan P. Wimmer, Kenneth C. Huber, George G. Latus, Michael L. Main Tags: Case Report Source Type: research

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