Tuesday, June 14, 2016

Left atrial appendage occlusion for stroke prevention in atrial fibrillation

From a recent review:

A single device has now received regulatory approval for patients at increased risk of stroke but in whom there are felt to be increased risks of bleeding making chronic anticoagulation less optimal. The approved indication for the WATCHMAN device in the US is for patients with nonvalvular AF who are at increased risk for stroke and systemic embolism based on CHADS 2 or CHA 2 DS 2 -VASc scores, deemed by their physicians to be suitable for warfarin, but who “have an appropriate rationale to seek a nonpharmacologic alternative to warfarin. “In Europe, LAA occlusion devices have received CE mark and are currently being used in clinical practice. Currently the European Society of Cardiology guidelines on AF 117 recommend that LAA closure may be considered in patients with high stroke risk who also have contraindications for long-term oral anticoagulation.

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