Zhang Chengxiang, Lu Hao, Zhu Yuansong
Department of General Medicine, The First Affiliated Hospital of Chongqing Medical University, 400016 Chongqing, China.
Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, 400016 Chongqing, China.
Rev Cardiovasc Med. 2023 Dec 25;24(12):360. doi: 10.31083/j.rcm2412360. eCollection 2023 Dec.
Atrial fibrillation (AF) is one the most prevalent arrhythmias globally and is associated with a significantly higher risk of morbidity and mortality, including an up to five-fold increase in risk of stroke. While oral anticoagulation therapy remains the standard approach for stroke prevention in nonvalvular AF, left atrial appendage occlusion (LAAO) has emerged as a viable alternative for patients who are intolerant to long-term oral anticoagulation therapy. However, selecting appropriate candidates for LAAO requires a comprehensive evaluation that considers various clinical factors, although this presents a challenge in clinical practice. This review aims to provide an overview of the current recommendations for patient selection in LAAO procedures and the key factors that need to be considered both before and after the procedure, as well as the ongoing advancements in this field that may facilitate the selection of patients for LAAO.
心房颤动(AF)是全球最常见的心律失常之一,与发病率和死亡率显著升高相关,包括中风风险增加高达五倍。虽然口服抗凝治疗仍然是非瓣膜性AF患者预防中风的标准方法,但对于不耐受长期口服抗凝治疗的患者,左心耳封堵术(LAAO)已成为一种可行的替代方法。然而,为LAAO选择合适的候选人需要综合评估,考虑各种临床因素,尽管这在临床实践中是一项挑战。本综述旨在概述LAAO手术患者选择的当前建议、手术前后需要考虑的关键因素,以及该领域可能有助于选择LAAO患者的持续进展。