title: Role for the left atrial appendage occlusion device in managing thromboembolic risk in atrial fibrillation.
abstract: Only 50% of patients who would benefit from warfarin therapy for atrial fibrillation (AF) receive treatment because of clinical concerns regarding chronic anti-coagulation. Percutaneous strategies to treat AF, including pulmonary vein isolation with a curative intent or atrioventricular nodal ablation and implantation of a permanent pacemaker for palliative rate control, have not eliminated the need to manage thromboembolic risk. With the development of a percutaneous left atrial appendage (LAA) occlusion device (the WATCHMAN percutaneous left atrial appendage occluder - Atritech Inc., Plymouth, MN, USA) for thromboembolic protection in non-valvular AF a significant therapeutic option for select patients may be available. We present the first case performed in Australia (24 November 2009) and explore this new methodology.
authors.affiliation: Monash Cardiovascular Research Centre, Monash Heart and Monash University Department of Medicine, Southern Health Network, Melbourne, Victoria, Australia. manojobey@yahoo.com
authors.forename: M N
authors.initials: MN
authors.lastname: Obeyesekere
authors.forename: S
authors.initials: S
authors.lastname: Lockwood
authors.forename: P
authors.initials: P
authors.lastname: Mottram
authors.forename: J F
authors.initials: JF
authors.lastname: Alison
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D020517:Atrial Appendage / Q000000981:diagnostic imaging / Q000601:surgery*; D001281:Atrial Fibrillation / Q000150:complications*; D006328:Cardiac Catheterization; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D002546:Ischemic Attack, Transient / Q000150:complications; D057240:Patient Preference / Q000523:psychology; D012306:Risk; D018570:Risk Assessment; D055989:Septal Occluder Device / Q000523:psychology; D013923:Thromboembolism / Q000517:prevention & control*; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D014859:Warfarin / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D014859:Warfarin; D001241:Aspirin