Potpara Tatjana, Grygier Marek, Haeusler Karl Georg, Nielsen-Kudsk Jens Erik, Berti Sergio, Genovesi Simonetta, Marijon Eloi, Boveda Serge, Tzikas Apostolos, Boriani Giuseppe, Boersma Lucas V A, Tondo Claudio, Potter Tom De, Lip Gregory Y H, Schnabel Renate B, Bauersachs Rupert, Senzolo Marco, Basile Carlo, Bianchi Stefano, Osmancik Pavel, Schmidt Boris, Landmesser Ulf, Doehner Wolfram, Hindricks Gerhard, Kovac Jan, Camm A John
Medical Faculty, University of Belgrade, University Clinical Centre of Serbia, Belgrade, Serbia.
1st Department of Cardiology, Poznan University School of Medical Sciences, Poznan, Poland.
Thromb Haemost. 2025 Sep;125(9):825-846. doi: 10.1055/a-2469-4896. Epub 2024 Dec 10.
Many patients with atrial fibrillation (AF) who are in need of stroke prevention are not treated with oral anticoagulation or discontinue treatment shortly after its initiation. Despite the availability of direct oral anticoagulants (DOACs), such undertreatment has improved somewhat but is still evident. This is due to continued risks of bleeding events or ischemic strokes while on DOAC, poor treatment compliance, or aversion to anticoagulant therapy. Because of significant improvements in procedural safety over the years left atrial appendage closure (LAAC), using a catheter-based, device implantation approach, is increasingly favored for the prevention of thromboembolic events in AF patients who cannot have long-term oral anticoagulation. This article is an executive summary of a practical guide recently published by an international expert consensus group, which introduces the LAAC devices and briefly explains the implantation technique. The indications and device follow-up are more comprehensively described. This practical guide, aligned with published guideline/guidance, is aimed at those non-implanting physicians who may need to refer patients for consideration of LAAC.
许多需要预防中风的心房颤动（AF）患者未接受口服抗凝治疗，或在开始治疗后不久就停止治疗。尽管有直接口服抗凝剂（DOACs），但这种治疗不足的情况虽有所改善但仍很明显。这是由于在使用DOACs时出血事件或缺血性中风的持续风险、治疗依从性差或对抗凝治疗的反感。由于多年来手术安全性有了显著提高，采用基于导管的装置植入方法进行左心耳封堵（LAAC），越来越多地被用于预防无法进行长期口服抗凝治疗的AF患者发生血栓栓塞事件。本文是一个国际专家共识小组最近发表的实用指南的执行摘要，该指南介绍了LAAC装置并简要解释了植入技术。对适应症和装置随访进行了更全面的描述。本实用指南与已发表的指南/指导意见一致，针对的是那些可能需要将患者转介以考虑LAAC的非植入医生。
