Kansas City Heart Rhythm Institute, Overland Park, KS, USA.
Curr Cardiol Rep. 2023 Sep;25(9):909-915. doi: 10.1007/s11886-023-01913-7. Epub 2023 Aug 16.
Left atrial appendage closure (LAAC) has shown to be non-inferior to oral anticoagulation (OAC) for non-valvular atrial fibrillation (AF). LAAC is now becoming a leading method for stroke prophylaxis in patients who have atrial fibrillation and are unable to tolerate OAC. There are currently two FDA-approved endocardial closure devices, namely, the Watchman FLX and Amplatzer Amulet.
Current data highlights that both devices offer similar efficacy and safety for LAAC. While the two devices differ in terms of intraprocedural complication rates, they offer similar short- to long-term outcomes in regard to peri-device leaks, device-related thrombosis, and mortality. With similar risk and safety profiles, both devices are indicated for patients who are unable to tolerate OAC. Newer clinical studies are directed to establish the efficacy of both devices as the primary method for stroke prevention in AF as an alternate to OAC.
左心耳封堵术（LAAC）在非瓣膜性心房颤动（AF）患者中已被证明不劣于口服抗凝药（OAC）。LAAC 现在已成为不能耐受 OAC 的房颤患者预防中风的主要方法。目前有两种获得 FDA 批准的心脏内封堵装置，即 Watchman FLX 和 Amplatzer Amulet。
目前的数据强调，这两种装置在 LAAC 中的疗效和安全性相似。尽管两种装置在术中并发症发生率方面有所不同，但在器械相关漏、器械相关血栓形成和死亡率方面，它们提供了相似的短期至长期结果。鉴于相似的风险和安全性特征，两种装置均适用于不能耐受 OAC 的患者。新的临床研究旨在确定这两种装置作为替代 OAC 的 AF 预防中风的主要方法的疗效。
