Plugs for left atrial appendage occlusion: an overview of available devices. (1st November 2020)

• Record Type: Journal Article
• Authors: Obeid, Slayman; Nietlispach, Fabian; Meier, Bernhard
• Is Part Of: Expert review of medical devices. Volume 17:Number 11(2020)
• Page Start: 1145
• Page End: 1154
• Publication Date: 2020-11-01
• Subjects: Atrial fibrillation -- interventional cardiology -- left atrial appendage closure -- non-valvular atrial fibrillation -- stroke prevention; Medical instruments and apparatus -- Periodicals; 610.28
• DOI: 10.1080/17434440.2020.1837621
• Languages: English
• ISSNs: 1743-4440

Abstract

ABSTRACT: Introduction: Approximately one-third of all ischemic strokes and the ensuing health and economic burden can be attributed to the presence of atrial fibrillation (AF). The global prevalence of AF continues to rise, thus making it by far the most common diagnosed cardiac arrhythmia. Percutaneous left atrial appendage (LAA) occlusion or obliteration has been developed to protect from the occurrence of stroke in patients with nonvalvular AF. Areas covered: We address the characteristics and techniques for implantation as well as some clinical registries and randomized trials of the various catheter-based devices for the occlusion of the LAA that are either currently available or in the clinical evaluation stage. Expert opinion: Over less than 2 decades, LAA occlusion progressed from being a concept applied in a few specialized centers to a globally recognized procedure implemented in numerous hospitals as part of daily interventional practice. The respective devices are to date safer and easier to deploy than initially. Periprocedural and postprocedural complications will continue to decrease as already evident from prospective randomized trials and registries. Although current indications focus on patients with nonvalvular AF and contraindications for oral anticoagulation, it is all but certain that the future will bring a widening in the spectrum of indications, applicability, and usage of these devices.