An International Consensus Practical Guide on Left Atrial Appendage Closure for the Non-implanting Physician: Executive Summary
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.
Authors
- Éloi Marijon (ORCID: https://orcid.org/0000-0001-7227-3428)
- Jan Kovac (ORCID: https://orcid.org/0000-0002-2007-888X)
- Karl Georg Hæusler (ORCID: https://orcid.org/0000-0002-6389-5054)
- A. John Camm (ORCID: https://orcid.org/0000-0002-2536-2871)
- Pavel Osmančík (ORCID: https://orcid.org/0000-0003-0482-4448)
- Marco Senzolo (ORCID: https://orcid.org/0000-0002-7261-6520)
- Jens Erik Nielsen‐Kudsk (ORCID: https://orcid.org/0000-0002-6473-2900)
- Gerhard Hindricks (ORCID: https://orcid.org/0000-0002-0132-0773)
- Marek Grygier (ORCID: https://orcid.org/0000-0002-1134-7099)
- Gregory Y.H. Lip (ORCID: https://orcid.org/0000-0002-7566-1626)
- Boris Schmidt (ORCID: https://orcid.org/0000-0001-5347-9906)
- Serge Bovéda (ORCID: https://orcid.org/0000-0002-1280-7042)
- Apostolos Tzikas (ORCID: https://orcid.org/0000-0001-6968-2191)
- Tom J. R. De Potter (ORCID: https://orcid.org/0000-0003-1424-114X)
- Stefano Bianchi (ORCID: https://orcid.org/0000-0003-3981-6325)
- Sérgio Luis Berti (ORCID: https://orcid.org/0000-0002-5244-0556)
- Claudio Tondo (ORCID: https://orcid.org/0000-0002-8500-8313)
- Carlo Basile (ORCID: https://orcid.org/0000-0001-8152-5471)
- Tatjana Potpara (ORCID: https://orcid.org/0000-0001-6285-6902)
- Lucas V.A. Boersma (ORCID: https://orcid.org/0000-0003-4591-4220)
- Wolfram Doehner (ORCID: https://orcid.org/0000-0001-7598-708X)
- Ulf Landmesser (ORCID: https://orcid.org/0000-0002-0214-3203)
- Rupert Bauersachs (ORCID: https://orcid.org/0000-0001-6192-1741)
- Simonetta Genovesi (ORCID: https://orcid.org/0000-0002-4699-4149)
- Renate B. Schnabel (ORCID: https://orcid.org/0000-0001-7170-9509)
- Giuseppe Boriani (ORCID: https://orcid.org/0000-0002-9820-4815)
Institutions
- Poznan University of Medical Sciences (PL)
- University of Modena and Reggio Emilia (IT)
- Vrije Universiteit Brussel (BE)
- University of Padua (IT)
- University of Liverpool (GB)
- University of Leicester (GB)
- St George's, University of London (GB)
- University of Milan (IT)
- Charles University (CZ)
- Aristotle University of Thessaloniki (GR)
- Interbalkan Medical Center (GR)
- Glenfield Hospital (GB)
- Aarhus University Hospital (DK)
- University of Belgrade (RS)
- Liverpool Heart and Chest Hospital (GB)
- Cardiovascular Center Bethanien (DE)
- Centro Cardiologico Monzino (IT)
- Universitäts-Kinderklinik Würzburg (DE)
- Assistance Publique – Hôpitaux de Paris (FR)
- Onze Lieve Vrouwziekenhuis Hospital (BE)
- Hôpital Européen Georges-Pompidou (FR)
- St. Antonius Ziekenhuis (NL)
- University Medical Center Hamburg-Eppendorf (DE)
- Azienda Ospedaliero-Universitaria di Modena (IT)
- Univerzitetski Klinički Centar Srbije (RS)
- Universitätsklinikum Würzburg (DE)
- German Centre for Cardiovascular Research (DE)
- Agaplesion Bethanien Krankenhaus (DE)
- IRCCS Istituto Auxologico Italiano (IT)
- Clinique Pasteur (FR)
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin (DE)
- Agaplesion Markus Hospital (DE)
- Amsterdam University Medical Centers (NL)
- University Hospital Kralovske Vinohrady (CZ)
- Fondazione Toscana Gabriele Monasterio (IT)
- Regione Toscana
- Liverpool John Moores University (GB)
- University of Milano-Bicocca (IT)
- Charité - Universitätsmedizin Berlin (DE)
- Aalborg University (DK)
Publication Details
- Journal
- Thrombosis and Haemostasis
- Published
- 2024-12-10
- DOI
- https://doi.org/10.1055/a-2469-4896
- Citations
- 5
- Primary Topic
- Atrial Fibrillation Management and Outcomes
- Type
- article
- Field-Weighted Citation Impact
- 2.01
Funders
- Bristol-Myers Squibb
- Pfizer
- AstraZeneca
- Sanofi
- Alexion Pharmaceuticals
- Edwards Lifesciences
- Boston Scientific Corporation
- Deutsches Zentrum für Herz-Kreislaufforschung
- Amarin Corporation
- National Institute for Health and Care Research
- European Commission
- Bayer HealthCare
- Bundesministerium für Bildung und Forschung
- Daiichi-Sankyo
- Deutsche Herzstiftung
- Vifor Pharma
- Novo Nordisk Fonden
- Sun Pharma
- MicroPort
- Biosense Webster
- Daiichi Sankyo Europe