Barletta Valentina, Alberti Mattia, Agostini Riccardo, Pizzino Fausto, Trimarchi Giancarlo, D'Alfonso Maria Grazia, Solari Marco, Zucchelli Giulio, Cresti Alberto
Department of Cardiac-Thoracic and Vascular, Second Division of Cardiology, Pisa University Hospital, 56100 Pisa, Italy.
Department of Surgical, Medical and Molecular Pathology and Critical Area, Cardiology Division, University of Pisa, 56126 Pisa, Italy.
J Clin Med. 2025 May 21;14(10):3607. doi: 10.3390/jcm14103607.
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in adults and is associated with significant morbidity and mortality, including an increased risk of stroke, heart failure, dementia, and recurrent hospitalizations. As life expectancy rises, both the incidence and prevalence of AF continue to grow. Stroke prevention remains a cornerstone of AF management, with oral anticoagulation being the primary strategy to reduce thromboembolic risk. However, despite their advantages, direct oral anticoagulants do not completely eliminate the risk of bleeding complications. For patients in whom anticoagulation is contraindicated, poorly tolerated, or ineffective at preventing AF-related stroke, interventional alternatives have gained traction. The left atrial appendage (LAA), a primary site of thrombus formation in AF, can be occluded through a catheter-based procedure known as left atrial appendage closure (LAAC) or left atrial appendage occlusion (LAAO). This review aims to provide imaging specialists with a comprehensive understanding of their role in LAAC, underscoring the importance of a multidisciplinary approach to enhance patient selection, procedural success, and long-term efficacy.
心房颤动（AF）是成年人中最常见的持续性心律失常，与显著的发病率和死亡率相关，包括中风、心力衰竭、痴呆和再次住院风险增加。随着预期寿命的延长，AF的发病率和患病率持续上升。预防中风仍然是房颤管理的基石，口服抗凝是降低血栓栓塞风险的主要策略。然而，尽管直接口服抗凝剂有其优势，但并不能完全消除出血并发症的风险。对于抗凝治疗禁忌、耐受性差或在预防房颤相关中风方面无效的患者，介入治疗替代方案越来越受到关注。左心耳（LAA）是房颤血栓形成的主要部位，可通过一种称为左心耳封堵（LAAC）或左心耳闭塞（LAAO）的导管介入程序进行封堵。本综述旨在让影像专家全面了解他们在LAAC中的作用，强调多学科方法对于优化患者选择、提高手术成功率和长期疗效的重要性。
