title: Mechanical closure devices for atrial fibrillation.
abstract: Atrial fibrillation (AF) is the most commonly sustained arrhythmia and is a major cause of stroke and systemic embolism. Chronic oral anticoagulation reduces this risk, but at the cost of increased bleeding. In addition, a substantial proportion of AF patients who are at moderate-to-high risk for stroke are undertreated due to real or perceived contraindications. The major source of thromboembolism in AF appears to be the left atrial appendage (LAA). Therefore, device closure of the LAA represents a mechanical approach to stroke prevention in AF patients. In this review, we describe the rationale for device closure of the LAA, summarize the current dataset for LAA closure devices, and set forth a framework to help guide patient selection for device therapy.
authors: Scripps Clinic, La Jolla, CA. Electronic address: price.matthew@scrippshealth.org.
authors: Matthew J
authors: MJ
authors: Price
authors: Mayo Clinic College of Medicine, Rochester, MN.
authors: David R
authors: DR
authors: Holmes
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use; D020517:Atrial Appendage / Q000503:physiopathology*; D001281:Atrial Fibrillation / Q000150:complications / Q000628:therapy; D006328:Cardiac Catheterization / Q000295:instrumentation / Q000379:methods; D000075202:Contraindications; D006470:Hemorrhage / Q000139:chemically induced / Q000517:prevention & control; D006801:Humans; D017063:Outcome Assessment, Health Care; D018579:Patient Selection; D020521:Stroke / Q000209:etiology / Q000517:prevention & control; D053831:Surgical Fixation Devices; D013923:Thromboembolism / Q000209:etiology / Q000517:prevention & control
chemical_list: D000925:Anticoagulants