EP Fellows Curriculum: Left atrial appendage closure for atrial fibrillation-EP Fellows Curriculum: Left atrial appendage closure for atrial fibrillation

EP Fellows Curriculum: Left atrial appendage closure for atrial fibrillation

Video Transcription

Video Summary

Dr. Lin discusses left atrial appendage closure for stroke prevention in patients with atrial fibrillation. He begins by highlighting the high bar that left atrial appendage closure must meet in terms of stroke reduction compared to other treatments such as warfarin. He explains that while warfarin has shown a remarkable reduction in stroke risk, it has dosing difficulties and interactions. He also discusses the efficacy and safety of left atrial appendage closure using devices like the Watchman and Amulet. He presents data from trials such as PROTECT and PREVAIL, which show non-inferiority to warfarin but have some safety concerns. He also touches on the use of direct oral anticoagulants and their limitations. Dr. Lin also explores the role of left atrial appendage closure in rhythm management of atrial fibrillation, including the safety of cardioversion in patients with a Watchman device. He also discusses the potential benefit of left atrial appendage closure in combination with pulmonary vein isolation in reducing atrial fibrillation burden. Dr. Lin concludes by mentioning ongoing clinical trials such as AMAZE, which aim to further investigate the role of left atrial appendage closure in comprehensive atrial fibrillation management.

Keywords

left atrial appendage closure

stroke prevention

atrial fibrillation

warfarin

Watchman

Amulet

direct oral anticoagulants

rhythm management

clinical trials