title: Appraising the safety and efficacy profile of left atrial appendage closure in 2016 and the future clinical perspectives. Results of the EAPCI LAAC survey.
abstract: OBJECTIVE
  The aim of this study was to determine the opinion of the scientific community regarding percutaneous left atrial appendage closure (LAAC). The main focus of the survey was on concerns and expectations regarding the safety and efficacy profile of LAAC in clinical practice and on current and future clinical perspectives.
  
  
  RESULTS
  A voluntary web-based survey was distributed by the European Association of Percutaneous Coronary Interventions (EAPCI) to all individuals registered on the EuroIntervention mailing list (n=21,800). A total of 724 physicians responded to the survey, of whom 31.8% had first operator experience with LAAC. Exclusive use of the Amulet (34.4%) or WATCHMAN (30.3%) was similar, but the former was the most frequently used device in Europe. The majority of respondents (59.3%) deemed LAAC to be as effective as, but safer than oral anticoagulants (OAC) in reducing stroke risk. Periprocedural complications (40.3%) and cost (28.8%) were the major concerns. Most practitioners did not consider novel oral anticoagulants (NOACs) to be a deterrent for performing LAAC procedures. Moreover, a history of serious haemorrhage was not deemed necessary to justify LAAC for 59.8% of physicians.
  
  
  CONCLUSIONS
  The results of this survey reveal a high level of confidence in percutaneous LAAC amongst surveyed interventional cardiologists, with the majority believing it to be as effective as OAC in terms of stroke prevention and safer in terms of bleeding risk.
authors.affiliation: Bern University Hospital, Bern, Switzerland.
authors.forename: Andrea
authors.initials: A
authors.lastname: Santucci
authors.forename: Robert A
authors.initials: RA
authors.lastname: Byrne
authors.forename: Andreas
authors.initials: A
authors.lastname: Baumbach
authors.forename: Roisin
authors.initials: R
authors.lastname: Colleran
authors.forename: Michael
authors.initials: M
authors.lastname: Haude
authors.forename: Stephan
authors.initials: S
authors.lastname: Windecker
authors.forename: Marco
authors.initials: M
authors.lastname: Valgimigli
mesh_terms: D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use*; D020517:Atrial Appendage / Q000503:physiopathology*; D001281:Atrial Fibrillation / Q000150:complications / Q000188:drug therapy*; D005060:Europe; D006470:Hemorrhage / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects; D055989:Septal Occluder Device / Q000009:adverse effects; D020521:Stroke / Q000188:drug therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014859:Warfarin / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D014859:Warfarin