Novel stroke risk reduction in atrial fibrillation: left atrial appendage occlusion with a focus on the Watchman closure device

Abstract

Atrial fibrillation (AF) remains an important clinical problem with severe complications such as stroke, which especially harms those with risk factors as calculated by the CHADS 2 or CHA 2 DS 2 -VASc. Until now, no therapy has proven 100% effective against AF. Since the left atrial appendage (LAA) is the most prominent nonvalvular AF-related thromboembolic source and (novel) oral anticoagulant [(N)OAC] carries the hazard of bleeding, LAA occlusion may be an alternative, especially in patients who are ineligible for (N)OAC therapy. In this review, we discuss several LAA occlusion techniques with a focus on the Watchman device since this device is the most thoroughly studied device of all.

Decreased eGFR Is Associated With Ischemic Stroke in Patients With Dilated Cardiomyopathy

“…Well-known risk factors for ischemic stroke include smoking, alcohol consumption, age, sex, hyperlipidemia, abnormal glucose metabolism, hypertension, AF, heart valve disease, ischemic heart disease, carotid atherosclerosis, and hyperhomocysteinemia. [14][15][16][17] In this study, 55 (7.1%) hospitalized patients with DCM had experienced ischemic stroke. By comparing the clinical characteristic data of the 55 patients with stroke and the 724 patients without stroke, no significant difference was found between the 2 groups for a series of variables, including age, sex, serum creatinine, hypertension, diabetes mellitus, AF, right atrial diameter, left ventricular diameter, and homocysteine.…”

Perioperative Treatment with Rivaroxaban and Dabigatran on Changes of Coagulation and Platelet Activation Biomarkers following Left Atrial Appendage Closure

“…Left atrial appendage (LAA) constitutes a critical of thrombosis in patients with atrial fibrillation (AF) [ 1 ]. More than 90% of thrombus in patients with nonvalvular atrial fibrillation (NVAF) originates from LAA, prompting the consideration of left atrial appendage closure (LAAC) as an alternative approach for stroke prevention in patients with NVAF [ 2 , 3 ]. Long-term follow-up studies have indicated that LAAC intervention can mitigate the thrombotic risk associated with LAA thrombus formation, concurrently minimizing the bleeding risks associated with anticoagulant use [ 4 , 5 ].…”