心房颤动(AF)是全球老年患者中最常见的心律失常和血栓栓塞事件的原因。房颤与心脏栓塞导致的发病率和死亡率的风险显著增加相关。主要来自左心耳(LAA)血栓。口服抗凝治疗是有效降低房颤患者血栓栓塞事件风险的标准治疗方法。然而,抗凝治疗增加出血风险。LAA封堵术(LAAC)最近已被引入作为血栓栓塞事件的可行机械预防性干预措施,同时将出血风险降至最低。经导管LAAC设备在过去十年中发展,一些正在进行的试验已经证明了新一代设备的安全性和结局的改善.这篇综述总结了关于LAAC作为药物治疗替代方案的当前观点和结果。
Atrial fibrillation (AF) is the most common cardiac arrhythmia and the cause of thromboembolic events in elderly patients worldwide. AF is associated with a significantly increased risk of morbidity and mortality due to cardiac emboli, primarily from left atrial appendage (LAA) thrombus. Oral anticoagulation therapy is the standard treatment to effectively reduce the risk of thromboembolic events in patients with AF. However, anticoagulation treatment increases bleeding risk. LAA closure (LAAC) has recently been introduced as a feasible mechanical preventive intervention for thromboembolic events while minimizing the risk of bleeding. Transcatheter LAAC devices have evolved in the past decade, and several ongoing trials have demonstrated the improvements of safety and outcomes in newer generation devices. This
review summarizes the current perspectives and outcomes regarding LAAC as an alternative to pharmacologic therapy.