ANMCO/AIAC/SICI-GISE/SIC/SICCH Consensus Document: Percutaneous occlusion of the left atrial appendage in non-valvular atrial fibrillation patients: Indications, patient selection, staff skills, organisation, and training

Gavino Casu, Michele Massimo Gulizia, Giulio Molon, Patrizio Mazzone, Andrea Audo, Giancarlo Casolo, Emilio Di Lorenzo, Michele Portoghese, Christian Pristipino, Renato Pietro Ricci, Sakis Themistoclakis, Luigi Padeletti, Claudio Tondo, Sergio Berti, Jacopo Andrea Oreglia, Gino Gerosa, Marco Zanobini, Gian Paolo Ussia, Giuseppe Musumeci, Francesco RomeoRoberto Di Bartolomeo

Research output: Contribution to journalArticlepeer-review

Abstract

Atrial fibrillation (AF) is the most common arrhythmia and its prevalence is increasing due to the progressive aging of the population. About 20% of strokes are attributable to AF and AF patients are at five-fold increased risk of stroke. The mainstay of treatment of AF is the prevention of thromboembolic complications with oral anticoagulation therapy. Drug treatment for many years has been based on the use of vitamin K antagonists, but recently newer and safer molecules have been introduced (dabigatran etexilate, rivaroxaban, apixaban, and edoxaban). Despite these advances, many patients still do not receive adequate anticoagulation therapy because of contraindications (relative and absolute) to this treatment. Over the last decade, percutaneous closure of left atrial appendage, main site of thrombus formation during AF, proved effective in reducing thromboembolic complications, thus offering a valid medical treatment especially in patients at increased bleeding risk. The aim of this consensus document is to review the main aspects of left atrial appendage occlusion (selection and multidisciplinary assessment of patients, currently available methods and devices, requirements for centres and operators, associated therapies and follow-up modalities) having as a ground the significant evolution of techniques and the available relevant clinical data.

Original languageEnglish
Pages (from-to)D333-D353
JournalEuropean Heart Journal, Supplement
Volume19
DOIs
Publication statusPublished - May 1 2017

Keywords

  • Atrial fibrillation
  • Left atrial appendage occlusion

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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