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Left atrial appendage occlusion: Fighting the “dark side” of atrial fibrillation
Author(s) -
Meucci Francesco,
Di Mario Carlo
Publication year - 2017
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.26944
Subject(s) - medicine , left atrial appendage occlusion , atrial fibrillation , adverse effect , incidence (geometry) , cardiology , stroke (engine) , major bleeding , occlusion , retrospective cohort study , surgery , warfarin , mechanical engineering , physics , optics , engineering
Key points In this real world UK retrospective experience LAAO confirms its safety profile with one procedure related death (0.25%), and 3.5% incidence of major adverse events. There is a significant learning curve effect (acute major events were reduced from 6.5 to 0.5% between first and second half of enrollment) The two most widely used devices (Watchman and Amplatzer) did not differ in terms of safety and efficacy in immediate success (95%) and late reduction of expected ischemic events, confirming a class effect of LAAO therapy In a rapidly changing environment, further research is needed to understand whether LAAO should remain confined to a niche group with absolute contraindications to OAT or can be extended to patients at high bleeding risk with both VKA and NOACs.