Atrial fibrillation (AF) is associated with a 5-fold increase in the risk of ischemic stroke.1 Left atrial appendage (LAA) closure reduces the risk of stroke in non-valvular AF (NVAF) patients who are seeking an alternative to oral anticoagulants.2,3
2016 EUROPEAN SOCIETY OF CARDIOLOGY (ESC) GUIDELINES FOR THE MANAGEMENT OF ATRIAL FIBRILLATION DEVELOPED IN COLLABORATION WITH THE EUROPEAN ASSOCIATION OF CARDIOTHORACIC SURGERY (EACTS)¹
ACCESS TO ALL TREATMENT OPTIONS FOR AF
Structured support for lifestyle changes
Anticoagulation
Rate control
CATHETER AND SURGICAL INTERVENTIONS (ABLATION, LAA OCCLUDER, AF SURGERY, ETC.)
Antiarrhythmic drugs
Complex management decisions underpinned by an AF Heart Team
|
|
|
|---|---|---|
| After surgical occlusion or exclusion of the LAA, it is recommended to continue anticoagulation in at-risk patients with AF for stroke prevention | I | B |
| LAA occlusion may be considered for stroke prevention in patients with AF and contraindications for long-term oral anticoagulation treatment (e.g. those with a previous life- threatening bleed without reversible cause) | IIb | B |
| Surgical occlusion or exclusion of the LAA may be considered for stroke prevention in patients with AF undergoing open cardiac surgery. | IIb | B |
| Surgical occlusion or exclusion of the LAA may be considered for stroke prevention in patients with AF undergoing thoracoscopic AF surgery | IIb | B |
PROFESSOR HANS-CHRISTOPH DIENER
Prevention of stroke in patients with AF:
To learn more about the proof of concept studies that led to the current class IIb recommendation for LAAO in the management of AF, please click on the publication link below:
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- Kirchhof P, Benussi S, Kotecha D, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J. 2016;37(38):2893–2962. doi.org/10.1093/eurheartj/ehw210.
- Diener H-C, Landmesser U. Percutaneous left atrial appendage occlusion for stroke prevention in patients with atrial fibrillation. Future Neurol. 2020;15(3). doi.org/10.2217/fnl-2020-0001.