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Left atrial appendage occlusion in atrial fibrillation for stroke prevention: A systemic review.

Abstract：

BACKGROUND:Atrial fibrillation (AF) is an arrthymia characterized by increased risk of ventricle arrthymias and thromboembolism especially ischemic stroke. Most thrombus originated in the left atrial appendage, thus left atrial occlusion (LAAO) may be an effective alternative for stroke prevention in atrial fibrillation. OBJECTIVE:To assess the effect and safety of left atrial occlusion for stroke prevention in atrial fibrillation. METHODS AND RESULTS:We searched Pub Med, CENTRAL in The Cochrane Library, Embase, CBM-Disk, CNKI for published trials, ClinicalTrials.gov, ISI Proceedings for conference abstracts, and WHO International Clinical Trial registration Platform for ongoing studies. The search results were extracted, and then the quality of included studies was assessed. By RevMan 5.3, meta analysis was used if there was low heterogeneity. Three randomized controlled clinical trials involving 1165 participants were included (percutaneous 1114 in 2 trials, surgical 51 in 1 trial). The current data suggest that left atrial occlusion may be as efficacious as warfarin in stroke prevention (RR 0.78 [0.33, 1.84]) and mortality reduction (RR 0.68 [0.40, 1.16]) for AF. CONCLUSION:In contrast to warfarin left atrial occlusion with Watchman device may have the same effectivity in stroke reduction. Surgical LAAO may also get positive outcomes compared with warfarin, but owing to the small sample size the evidence is less powerful. Total outcomes of percutaneous and surgical LAAO support this approach.

journal_name

Int J Cardiol

journal_title

International journal of cardiology

authors

Zhou X,Zhang W,Lv W,Zhou Q,Li Y,Zhang L,Lu Y,Zhang J,Xing Q,Wang H,Tang B

doi

10.1016/j.ijcard.2015.10.011

subject

Has Abstract

pub_date

2016-01-15 00:00:00

pages

55-9

eissn

0167-5273

issn

1874-1754

pii

S0167-5273(15)30575-1

journal_volume

203

pub_type

杂志文章,评审

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