Current Cardiology Reports

, Volume 12, Issue 5, pp 413–421

Left Atrial Appendage Closure

Article

DOI: 10.1007/s11886-010-0122-9

Cite this article as:
Singh, I.M. & Holmes, D.R. Curr Cardiol Rep (2010) 12: 413. doi:10.1007/s11886-010-0122-9

Abstract

Stroke prevention is the primary goal in atrial fibrillation (AF) given its clinical and socioeconomic impact. With AF, the prevalence of thromboembolic stroke continues to rise and there is an urgent need to develop better strategies of stroke prevention. Warfarin, although effective when used appropriately, is burdened by underutilization, narrow therapeutic windows, and life-threatening bleeding complications. Novel pharmacologic agents have been plagued by off-target toxicity and only modest improvement in bleeding complications over warfarin. Because most thromboemboli arise from the left atrial appendage (LAA), surgical exclusion of the LAA is often used in AF patients undergoing cardiac surgery. Percutaneous device LAA closure has now been developed as an adjunct and as an alternative to pharmacotherapy in patients with AF. Promising randomized data are available with the WATCHMAN device, while several other devices are in various stages of clinical and preclinical development.

Keywords

Atrial fibrillationStrokeLeft atrial appendagePercutaneous closure

Clinical Trial Acronyms

ACTIVE

Atrial Fibrillation Clopidogrel Trial With Irbesartan for Prevention of Vascular Events

ASAP

ASA Plavix Feasibility Study With WATCHMAN Left Atrial Appendage Closure Technology

CAP

Continued Access PROTECT AF

EXCLUDE

Exclusion of the Left Atrial Appendage With the AtriClip LAA Exclusion Device in Patients Undergoing Concomitant Cardiac Surgery

LAAOS

Left Atrial Appendage Occlusion Study

LAAOS II

Left Atrial Appendage Occlusion Study II

MATCH

Management of Atherothrombosis With Clopidogrel in High-Risk Patients

PROTECT AF

WATCHMAN Left Atrial Appendage System for Embolic Protection in Patients With Atrial Fibrillation

RE-LY

Randomized Evaluation of Long-Term Anticoagulation Therapy

SPORTIF

Stroke Prevention Using an Oral Thrombin Inhibitor in Atrial Fibrillation

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Fellow of Interventional CardiologyMayo ClinicRochesterUSA
  2. 2.Division of Cardiovascular DiseasesMayo ClinicRochesterUSA