Interventional approach to reduce thromboembolic risk in patients with atrial fibrillation ineligible for oral anticoagulation.
The annual incidence of stroke in patients with nonrheumatic atrial fibrillation averages 5% per year and increases with age, left ventricular dysfunction, hypertension, diabetes or prior stroke. Since in nonrheumatic atrial fibrillation 91% of left atrial thrombi are located in the left atrial appendage, in patients ineligible for oral anticoagulation it was suggested the percutaneous closure of left atrial appendage as a therapeutic option to reduce embolic risk. In this article we report our initial experience with this procedure, which was uneventful and efficacious at short-term follow-up. In conclusion, the interventional approach in patients with atrial fibrillation ineligible for oral anticoagulation seems feasible and promising, and deserves further investigation.
Ramondo
Angelo
A
Department of Pharmacology and Anesthesiology, "Egidio Meneghetti", University of Padua, Padua, Italy. aramondoit@yahoo.it
Maiolino
Giuseppe
G
Napodano
Massimo
M
Isabella
Gianbattista
G
Tarantini
Giuseppe
G
Bonato
Raffaele
R
Pengo
Vittorio
V
Ponchia
Andrea
A
Iliceto
Sabino
S
D000284:Administration, Oral; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects; D020517:Atrial Appendage / Q000503:physiopathology*; D001281:Atrial Fibrillation / Q000628:therapy*; D021721:Balloon Occlusion / Q000295:instrumentation* / Q000379:methods; D006328:Cardiac Catheterization / Q000295:instrumentation* / Q000379:methods; D000075202:Contraindications; D006801:Humans; D008297:Male; D012307:Risk Factors; D013923:Thromboembolism / Q000517:prevention & control*
D000925:Anticoagulants