Stroke Prevention in Atrial Fibrillation: Is Left Atrial Appendage Closure Superior to Systemic Anticoagulation?

Nadeev Wijesuriya* and Syed Ahsan

Received: March 12, 2020;   Published: April 01, 2020

DOI: 10.32474/LOJPCR.2020.02.000127

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Abstract

Atrial fibrillation (AF) is the most common arrhythmia worldwide [1], and has significant associated morbidity, including increased risk of stroke. Stroke prevention in non-valvular AF (NVAF) is a dynamic, rapidly evolving and challenging field. Oral anticoagulation (OAC) is well established as the gold standard in stroke prevention for patients meeting risk criteria defined by the CHA2DS2-VASc score [2]. However, these patients are often elderly, with multiple co-morbidities including ischaemic heart disease (IHD), chronic kidney disease and frailty [3] which increase risk of bleeding. Clinicians face daily conundrums on how to balance these risks with the benefits of stroke protection. Left Atrial Appendage closure (LAAC) is an emerging technology which some believe may help to resolve these issues.

Introduction| Oral Anticoagulation in Stroke Prevention| Challenges of Oral Anticoagulation| Left Atrial Appendage Closure as a Stroke Prevention Strategy| Perspective: Current and Future Directions for LAA Closure| References|