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- Title
Left Atrial Appendage Epicardial Clip (AtriClip): Essentials and Post-Procedure Management.
- Authors
Bedeir, Kareem; Warriner, Susan; Kofsky, Edward; Gullett, Christopher; Ramlawi, Basel
- Abstract
Left atrial appendage exclusion is a viable alternative to anticoagulation for stroke risk reduction in atrial fibrillation patients. In this article we address the essentials and post-procedural management of left atrial appendage exclusion using the AtriClip. Ischemic strokes that are related to atrial fibrillation (AF) are the most devastating and the most disabling ischemic strokes due to larger emboli compared to carotid disease. Anticoagulation (AC) is the standard approach for stroke risk reduction in AF patients. Unfortunately, near 10 percent percent of AF patients who would benefit from AC (CHA2DS2-VASc score of 2 or more) have absolute contraindications for AC. A higher percentage may have relative contraindications. Moreover, among the patients who can be on AC, only sixty percent are able to maintain a therapeutic international normalized ratio (INR). This has traditionally left almost half of AF patients at a significant stroke risk without protection. The advent of newer non-vitamin K anticoagulants (NOACs) has slightly improved the problem given their improved intracranial bleeding profile, the inherent and still significant risk of bleeding from anticoagulation persists.
- Subjects
ATRIAL fibrillation; INTERNATIONAL normalized ratio
- Publication
JAFIB: Journal of Atrial Fibrillation, 2019, Vol 11, Issue 6, p1
- ISSN
1941-6911
- Publication type
Article