Open Access Open Access  Restricted Access Subscription Access
Open Access Open Access Open Access  Restricted Access Restricted Access Subscription Access

New Hope For Patients with Atrial Fibrillation


Affiliations
1 Department of Cardiology, Sakra World Hospital, Bangalore, India
     

   Subscribe/Renew Journal


Atrial fibrillation (AF) is a fairly common type of arrhythmia in elderly. The incidence of atrial fibrillation increases with age. The biggest risk for patients with AF is thromboembolism. Unfortunately, most of these embolic episodes affect the brain. Typically, cardiac–source emboli are larger and therefore, affect large vascular territories of the brain, leading to severely disabling strokes. Over the years, oral anticoagulation has significantly reduced the risk of embolism. Earlier, we had to struggle with titrating vitamin K antagonists, which have poor dose–response predictability and therefore, they either failed to protect or caused bleeding. Now, anticoagulation has become easier because of the availability of the Non-vitamin K antagonist anticoagulants. However, some patients cannot receive either of them because they have a high risk of bleeding or already have had clinical bleeding. This is a vexing clinical scenario. Fortunately, for such patients, the advent of a new therapy comes as a boon, i.e. Left Atrial Appendage Device Closure.
Subscription Login to verify subscription
User
Notifications
Font Size


  • Reddy VY, Doshi SK, Sievert H, et al. Percutaneous left atrial appendage closure for stroke prophylaxis in patients with atrial fibrillation: 2.3-Year Follow-up of the PROTECT AF (Watchman Left Atrial Appendage System for Embolic Protection in Patients with Atrial Fibrillation) Trial. Circulation 2013;127:720-9.
  • Holmes DR Jr, Kar S, Price MJ, et al. Prospective randomized evaluation of the Watchman Left Atrial Appendage Closure device in patients with atrial fibrillation versus long-term warfarin therapy: the PREVAIL trial. J Am Coll Cardiol 2014;64:1-12.
  • Holmes DR Jr, Doshi SK, Kar S, et al. Left Atrial Appendage Closure as an Alternative to Warfarin for Stroke Prevention in Atrial Fibrillation: A Patient-Level Meta-Analysis. J Am Coll Cardiol 2015;65:2614-23.
  • Tzikas A, Shakir S, Gafoor S, et al. Left atrial appendage occlusion for stroke prevention in atrial fibrillation: multicentre experience with the AMPLATZER Cardiac Plug. Euro Intervention 2016;11:1170-9.
  • Chugh SS, Havmoeller R, Narayanan K, et al. Worldwide epidemiology of atrial fibrillation: a Global Burden of Disease 2010 Study. Circulation 2014;129:837-47.

Abstract Views: 201

PDF Views: 1




  • New Hope For Patients with Atrial Fibrillation

Abstract Views: 201  |  PDF Views: 1

Authors

Sreekanth B. Shetty
Department of Cardiology, Sakra World Hospital, Bangalore, India

Abstract


Atrial fibrillation (AF) is a fairly common type of arrhythmia in elderly. The incidence of atrial fibrillation increases with age. The biggest risk for patients with AF is thromboembolism. Unfortunately, most of these embolic episodes affect the brain. Typically, cardiac–source emboli are larger and therefore, affect large vascular territories of the brain, leading to severely disabling strokes. Over the years, oral anticoagulation has significantly reduced the risk of embolism. Earlier, we had to struggle with titrating vitamin K antagonists, which have poor dose–response predictability and therefore, they either failed to protect or caused bleeding. Now, anticoagulation has become easier because of the availability of the Non-vitamin K antagonist anticoagulants. However, some patients cannot receive either of them because they have a high risk of bleeding or already have had clinical bleeding. This is a vexing clinical scenario. Fortunately, for such patients, the advent of a new therapy comes as a boon, i.e. Left Atrial Appendage Device Closure.

References