title: [ANMCO/AIAC/SICI-GISE/SIC/SICCH Consensus document: Percutaneous left atrial appendage occlusion in patients with nonvalvular atrial fibrillation: indications, patient selection, competences, organization, and operator training].
abstract: Atrial fibrillation (AF) is the most common arrhythmia and its prevalence is increasing due to the progressive aging of the population. About 20% of strokes are attributable to AF and AF patients are at 5-fold increased risk of stroke. The mainstay of treatment of AF is the prevention of thromboembolic complications with oral anticoagulation therapy. Drug treatment for many years has been based on the use of vitamin K antagonists, but recently newer and safer molecules have been introduced (dabigatran etexilate, rivaroxaban, apixaban and edoxaban). Despite these advances, many patients still do not receive adequate anticoagulation therapy because of contraindications (relative and absolute) to this treatment. Over the last decade, percutaneous closure of left atrial appendage, main site of thrombus formation during AF, proved effective in reducing thromboembolic complications, thus offering a valid medical treatment especially in patients at increased bleeding risk. The aim of this consensus document is to review the main aspects of left atrial appendage occlusion (selection and multidisciplinary assessment of patients, currently available methods and devices, requirements for centers and operators, associated therapies and follow-up modalities) having as a ground the significant evolution of techniques and the available relevant clinical data.
authors: Cardiologia-UTIC, Ospedale San Francesco, Nuoro.
authors: Gavino
authors: G
authors: Casu
authors: U.O.C. Cardiologia, Ospedale Garibaldi-Nesima, Azienda di Rilievo Nazionale e Alta Specializzazione "Garibaldi", Catania.
authors: Michele Massimo
authors: MM
authors: Gulizia
authors: U.O. Cardiologia, Ospedale Sacro Cuore, Negrar (VR).
authors: Giulio
authors: G
authors: Molon
authors: Unità Aritmologia ed Elettrofisiologia, Ospedale San Raffaele, Milano.
authors: Patrizio
authors: P
authors: Mazzone
authors: Divisione di Cardiochirurgia, Ospedale Civile SS. Antonio e Biagio, Alessandria.
authors: Andrea
authors: A
authors: Audo
authors: S.C. Cardiologia, Nuovo Ospedale Versilia, Lido di Camaiore (LU).
authors: Giancarlo
authors: G
authors: Casolo
authors: U.O. Cardiologia-UTIC, AORN Giuseppe Moscati, Avellino.
authors: Emilio
authors: E
authors: Di Lorenzo
authors: Cardiochirurgia, Ospedale SS. Annunziata, Sassari.
authors: Michele
authors: M
authors: Portoghese
authors: U.O.C. Emodinamica, Presidio Ospedaliero San Filippo Neri, Roma.
authors: Christian
authors: C
authors: Pristipino
authors: U.O.C. Cardiologia-UTIC, Presidio Ospedaliero San Filippo Neri, Roma.
authors: Renato Pietro
authors: RP
authors: Ricci
authors: U.O.S.D. Elettrofisiologia Elettrostimolazione, Ospedale dell'Angelo, Venezia Mestre.
authors: Sakis
authors: S
authors: Themistoclakis
authors: Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi, Firenze.
authors: Luigi
authors: L
authors: Padeletti
authors: Aritmologia, Centro Cardiologico Monzino, Milano.
authors: Claudio
authors: C
authors: Tondo
authors: U.O.C. Cardiologia Diagnostica e Interventistica, Fondazione Toscana "G. Monasterio", Ospedale del Cuore, Massa.
authors: Sergio
authors: S
authors: Berti
authors: Laboratorio di Emodinamica, Ospedale L. Sacco, Milano.
authors: Jacopo Andrea
authors: JA
authors: Oreglia
authors: Cardiochirurgia - Centro V. Gallucci, Azienda Ospedaliera di Padova, Padova.
authors: Gino
authors: G
authors: Gerosa
authors: Cardiochirurgia, Centro Cardiologico Monzino, Milano.
authors: Marco
authors: M
authors: Zanobini
authors: Dipartimento Medicina dei Sistemi, Università degli Studi di Roma "Tor Vergata", Roma.
authors: Gian Paolo
authors: GP
authors: Ussia
authors: Dipartimento Cardiovascolare, ASST Papa Giovanni XXIII, Bergamo.
authors: Giuseppe
authors: G
authors: Musumeci
authors: U.O.C. Cardiologia e Cardiologia Interventistica, Policlinico "Tor Vergata", Roma.
authors: Francesco
authors: F
authors: Romeo
authors: Roberto
authors: R
authors: Di Bartolomeo
mesh_terms: D000284:Administration, Oral; D000925:Anticoagulants / Q000008:administration & dosage*; D020517:Atrial Appendage / Q000601:surgery*; D001281:Atrial Fibrillation / Q000150:complications / Q000628:therapy*; D017115:Catheter Ablation; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006801:Humans; D018579:Patient Selection; D012307:Risk Factors; D055989:Septal Occluder Device; D020521:Stroke / Q000209:etiology / Q000517:prevention & control*; D013927:Thrombosis / Q000628:therapy*
chemical_list: D000925:Anticoagulants; D005343:Fibrinolytic Agents