Documento di posizione GISE/AIAC sui requisiti di processo diagnostico ed interventistico riferiti al trattamento della chiusura percutanea dell'auricola sinistra in pazienti affetti da fibrillazione atriale non valvolare

Translated title of the contribution: GISE/AIAC position paper on the requirements of the diagnostic process and interventional related treatment for percutaneous left atrial appendage occlusion in patients with non-valvular atrial fibrillation

Sergio Berti, Sakis Themistoclakis, Gennaro Santoro, Roberto De Ponti, Paolo Danna, Massimo Zecchin, Francesco Bedogni, Luigi Padeletti

Research output: Contribution to journalArticlepeer-review

Abstract

Thromboembolism from the left atrial appendage is the most feared complication in patients with atrial fibrillation (AF). The cornerstone for the management of chronic nonvalvular AF is stroke reduction with oral anticoagulation (OAC). However, poor compliance, maintaining a narrow therapeutic window, and major side effects such as bleeding have severely limited its use, creating a therapeutic dilemma. About 20% of AF patients do not receive OAC due to contraindications and less than half of AF patients are not on OAC due to reluctance of the prescribing physician and/or patient non-compliance. Fortunately, over the past decade, the introduction of percutaneous approaches for left atrial appendage occlusion has offered a viable alternative to the management of nonvalvular AF in patients with OAC contraindication. Occlusion devices such as the Amplatzer Cardiac Plug and Watchman device have shown their noninferiority to OAC for stroke prophylaxis with less bleeding complications, while more recently some new devices have been introduced. The aim of this position paper is to review the most relevant clinical aspects of left atrial appendage occlusion from patient selection to periprocedural and follow-up management. In addition, the importance of a medical team and an organizational environment adequate to optimize all the steps of this procedure is discussed.

Translated title of the contributionGISE/AIAC position paper on the requirements of the diagnostic process and interventional related treatment for percutaneous left atrial appendage occlusion in patients with non-valvular atrial fibrillation
Original languageItalian
Pages (from-to)524-526
Number of pages3
JournalGiornale Italiano di Cardiologia
Volume15
Issue number9
Publication statusPublished - Sep 1 2014

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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