title: Antithrombotic therapy after left atrial appendage closure.
abstract: It is important to prevent on-device thrombus formation without increasing the risk for bleeding complications after successful interventional left atrial appendage closure. Therefore, choosing the optimal antithrombotic therapy poses a challenging task. While major clinical studies investigated patients eligible for oral anticoagulation using vitamin K antagonists, the vast majority of implants in 'real life' are performed in patients with contraindications to oral anticoagulation after serious bleeding events. In this patient population, strategies using dual antiplatelet therapy were found to be a sound alternative; however, the optimal duration of antithrombotic therapy remains unclear. Future studies will have to investigate the role of direct anticoagulants for post-implant thrombus formation and address the question of whether left atrial appendage closure obviates the need for long-term aspirin therapy.
authors.affiliation: Cardioangiologisches Centrum Bethanien, AGAPLESION Markus Krankenhaus, Wilhelm-Epstein Str. 4, 60431 Frankfurt/Main, Germany.
authors.forename: Boris
authors.initials: B
authors.lastname: Schmidt
authors.forename: Kyoung Ryul Julian
authors.initials: KR
authors.lastname: Chun
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use*; D020517:Atrial Appendage / Q000187:drug effects* / Q000503:physiopathology; D001281:Atrial Fibrillation / Q000628:therapy*; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D055989:Septal Occluder Device; D020521:Stroke / Q000628:therapy
chemical_list: D000925:Anticoagulants; D005343:Fibrinolytic Agents
keywords: antithrombotic therapy; atrial fibrillation; left atrial appendage; occlusion; stroke