Left Atrial Appendage Closure after Ablation for Atrial Fibrillation.

• Tác giả: Federico M Asch, Lucas V A Boersma, Thomas Christen, David B DeLurgio, Henning Ebelt, Madhukar Gupta, Jeff S Healey, Troy Hounshell, Arvindh Kanagasundram, Eloi Marijon, George Mark, Devi G Nair, Jens Erik Nielsen-Kudsk, Jeffrey Olson, Jose Osorio, Saumil Oza, Chinmay Patel, Karen P Phillips, Vivek Y Reddy, Kristine Roy, Ashish Sadhu, Walid I Saliba, Boris Schmidt, Carsten Skurk, Kenneth M Stein, Sri Sundaram, Brad S Sutton, Oussama M Wazni, Katherine Wolski
• Ngôn ngữ: eng
• Ký hiệu phân loại: 383.122 Letters, postcards, sealed material
• Thông tin xuất bản: United States : The New England journal of medicine , 2025
• Bộ sưu tập: NCBI
• ID: 752129

Tóm tắt

 BACKGROUND: Oral anticoagulation is recommended after ablation for atrial fibrillation among patients at high risk for stroke. Left atrial appendage closure is a mechanical alternative to anticoagulation, but data regarding its use after atrial fibrillation ablation are lacking. METHODS: We conducted an international randomized trial involving 1600 patients with atrial fibrillation who had an elevated score (≥2 in men and ≥3 in women) on the CHA RESULTS: A total of 803 patients were assigned to undergo left atrial appendage closure, and 797 to receive anticoagulant therapy. The mean (±SD) age of the patients was 69.6±7.7 years, 34.1% of the patients were women, and the mean CHA CONCLUSIONS: Among patients who underwent catheter-based atrial fibrillation ablation, left atrial appendage closure was associated with a lower risk of non-procedure-related major or clinically relevant nonmajor bleeding than oral anticoagulation and was noninferior to oral anticoagulation with respect to a composite of death from any cause, stroke, or systemic embolism at 36 months. (Funded by Boston Scientific
  OPTION ClinicalTrials.gov number, NCT03795298.).