Bajwa Rizma Jalees, Kovell Lara, Resar Jon R, Arbab-Zadeh Armin, Mandal Kaushik, Calkins Hugh, Berger Ronald D
Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Division of Cardiac Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Clin Cardiol. 2017 Oct;40(10):825-831. doi: 10.1002/clc.22764. Epub 2017 Jul 27.
Atrial fibrillation (AF) is a commonly sustained atrial arrhythmia with associated morbidity and mortality. AF is associated with increased risk of thromboembolism and stroke, requiring use of anticoagulation. Anticoagulation decreases the risk of stroke but is associated with a higher risk of bleeding, necessitating discontinuation in some patients. The left atrial appendage is the likely source of thrombus in the majority of patients with AF. This has led to the development of left atrial appendage occlusion as a means to reduce stroke risk in patients who have a contraindication to long-term anticoagulation. Multiple implantable devices have surfaced in the last few years, with some promising prospects. The main purpose of this review is to highlight the indications and use of these devices for left atrial appendage occlusion.
心房颤动(AF)是一种常见的持续性房性心律失常,伴有相关的发病率和死亡率。AF与血栓栓塞和中风风险增加相关,需要使用抗凝治疗。抗凝治疗可降低中风风险,但与较高的出血风险相关,这使得一些患者需要停药。在大多数AF患者中,左心耳可能是血栓的来源。这促使了左心耳封堵术的发展,作为降低有长期抗凝治疗禁忌证患者中风风险的一种手段。在过去几年中出现了多种可植入装置,具有一些有前景的前景。本综述的主要目的是强调这些装置用于左心耳封堵的适应证和应用。