Published online Feb 26, 2017. doi: 10.4330/wjc.v9.i2.139
Peer-review started: July 16, 2016
First decision: September 30, 2016
Revised: November 20, 2016
Accepted: December 1, 2016
Article in press: December 3, 2016
Published online: February 26, 2017
Processing time: 224 Days and 17.5 Hours
Non-valvular atrial fibrillation is associated with a significantly increased risk of embolic stroke due to blood clot forming predominantly in the left atrial appendage (LAA). Preventive measures to avoid embolic events are permanent administration of anticoagulants or surgical closure of the LAA. Various clinical trials provide evidence about safety, effectiveness and therapeutic success of LAA occlusion using various cardiac occluder devices. The use of such implants for interventional closure of the LAA is likely to become a valuable alternative for stroke prevention, especially in patients with contraindication for oral anticoagulation as safety, clinical benefit and cost-effectiveness of LAA occlusion has recently been demonstrated.
Core tip: Non-valvular atrial fibrillation is associated with increased risk of embolic stroke. To date, risk-based anticoagulation is the cornerstore to avoid this. However, several patients have got absolute or relative contraindication to this and thus are undertreated. For these patient population the implantation of a local left atrial appendage occluder might be an alternative.