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STROKE RISK FACTORS

Atrial fibrillation (AF) is associated with a 5-fold increase in the risk of ischemic stroke.1 Left atrial appendage (LAA) closure reduces the risk of stroke in non-valvular AF patients (NVAF) who are seeking an alternative to oral anticoagulants.2,3

SWITCH TO THE interventional VIEW    For more information specific to interventional cardiology regarding LAA Occlusion

2016 EUROPEAN SOCIETY OF CARDIOLOGY (ESC) GUIDELINES FOR THE MANAGEMENT OF ATRIAL FIBRILLATION DEVELOPED IN COLLABORATION WITH THE EUROPEAN ASSOCIATION OF CARDIOTHORACIC SURGERY (EACTS)1


RECOMMENDATION


CLASS


LEVEL

After surgical occlusion or exclusion of the LAA, it is recommended to continue anticoagulation in at-risk patients with AF for stroke preventionIB
LAA occlusion may be considered for stroke prevention in patients with AF and contraindications for long-term oral anticoagulation treatment (e.g. those with a previous life-threatening bleed without reversible cause)
IIb

B
Surgical occlusion or exclusion of the LAA may be considered for stroke prevention in patients with AF undergoing open cardiac surgery.
IIb

B
Surgical occlusion or exclusion of the LAA may be considered for stroke prevention in patients with AF undergoing thoracoscopic AF surgery
IIb

B

ACCESS TO ALL TREATMENT OPTIONS FOR AF

  • Structured support for lifestyle changes
  • Anticoagulation
  • Rate control

CATHETER AND SURGICAL INTERVENTIONS (ABLATION, LAA OCCLUDER, AF SURGERY, ETC.)

  • Antiarrhythmic drugs
  • Complex management decisions underpinned by an AF Heart Team

 

PROFESSOR HANS-CHRISTOPH DIENER

PREVENTION OF STROKE IN PATIENTS WITH AF:

To learn more about the proof of concept studies that led to the current class IIb recommendation for LAAO in the management of AF, please click on the publication link below:

Diener H-C, Landmesser U. Percutaneous left atrial appendage occlusion for stroke prevention in patients with atrial fibrillation.

PUBLICATION

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References
  1. Kirchhof P, Benussi S, Kotecha D, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J. 2016;37(38):2893–2962. doi.org/10.1093/eurheartj/ehw210.
  2.  Diener H-C, Landmesser U. Percutaneous left atrial appendage occlusion for stroke prevention in patients with atrial fibrillation. Future Neurol. 2020;15(3).https://doi.org/10.2217/fnl-2020-0001.

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