Chronic oral anticoagulation (OAC) has traditionally been considered as the most effective
prophylaxis against thromboembolic events in patients with atrial fibrillation (AF).
However, as many as 20% of the patients with AF are not candidates for OAC.
1
,
2
Reasons for ineligibility range from intracranial bleeding (the most serious complication)
to increased propensity for mechanical injury (the least serious complication). The
resumption of OAC in patients who have suffered a life-threatening complication due
to OAC is associated with a much higher risk of such events in the future.Abbreviations:
AF (atrial fibrillation), AP (anteroposterior), CT (computed tomography), CTA (computed tomography angiography/angiogram), LA (left atrium/atrial), LAA (left atrial appendage), LAO (left anterior oblique), OAC (oral anticoagulation), RAO (right anterior oblique), RV (right ventricle/ventricular), TEE (transesophageal echocardiography)Keywords
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References
- Recent national pattern of warfarin use in atrial fibrillation.Circulation. 1998; 97: 1231-1233
- Anticoagulation in atrial fibrillation: does efficacy in clinical trials translate into effectiveness in practice?.Arch Intern Med. 1994; 154: 1945-1953
Bartus K, Bednarek J, Myc J, Kapelak B, Sadowski J, Lelakowski J, Yakubov SJ, Lee RJ. Feasibility of closed-chest ligation of the left atrial appendage in humans. Heart Rhythm 2011;8:188–193
- Percutaneous left atrial appendage suture ligation using the LARIAT in patients with atrial fibrillation: initial clinical experience.J Am Coll Cardiol. 2013; 62: 108-118
- Initial experience with a novel percutaneous left atrial appendage exclusion device in patients with atrial fibrillation, increased stroke risk, and contraindications to anticoagulation.Am J Cardiol. 2013; 111: 869-873
Article info
Publication history
Published online: January 23, 2014
Footnotes
☆Dr Lee is a consultant and equity holder of SentreHEART, Inc, the device company that manufactures the LARIAT device.
Identification
Copyright
© 2014 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.
