Practical guide on left atrial appendage closure for the non-implanting physician: an international consensus paper.

Autor:	Potpara T; Medical Faculty, University of Belgrade, Belgrade, Serbia.; University Clinical Centre of Serbia, Belgrade, Serbia., Grygier M; 1st Department of Cardiology, Poznan University School of Medical Sciences, Poznan, Poland., Häusler KG; Department of Neurology, Universitätsklinikum Würzburg (UKW), Würzburg, Germany., Nielsen-Kudsk JE; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark., Berti S; Ospedale del Cuore, Fondazione CNR Regione Toscana G. Monasterio, Pisa, Italy., Genovesi S; School of Medicine and Surgery, University of Milano-Bicocca, Nephrology Clinic, Monza, Italy.; Istituto Auxologico Italiano, IRCCS, Milan, Italy., Marijon E; Division of Cardiology, European Georges Pompidou Hospital, AP-HP, Paris, France., Boveda S; Cardiology, Heart Rhythm Management Department, Clinique Pasteur, Toulouse, France.; Cardiologie Clinique Pasteur, Brussels University VUB, Brussels, Belgium., Tzikas A; Ippokrateio Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Greece.; Structural and Congenital Heart Disease, European Interbalkan Medical Centre, Thessaloniki, Greece., Boriani G; Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy., Boersma LVA; Cardiology Department, St. Antonius Hospital Nieuwegein/Amsterdam University Medical Centers, Amsterdam, Netherlands., Tondo C; Centro Cardiologico Monzino, IRCCS, Department of Clinical Electrophysiology & Cardiac Pacing, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy., De Potter T; Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium., Lip GYH; Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK.; Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark., Schnabel RB; Department of Cardiology, University Heart and Vascular Centre Hamburg, Hamburg, Germany.; German Centre for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany., Bauersachs R; Cardioangiology Center Bethanien CCB, Frankfurt, Germany.; Center for Vascular Research, Munich, Germany., Senzolo M; Department of Surgery, Oncology and Gastroenterology, University Hospital of Padua, Padua, Italy., Basile C; Division of Nephrology, Miull General Hospital, Acquaviva delle Fonti, Italy.; EuDial Working Group of the European Renal Association, Acquaviva delle Fonti, Italy., Bianchi S; Nephrology and Dialysis Unit, ASL Toscana NordOvest, Livorno, Italy., Osmancik P; Department of Cardiology, University Hospital Kralovske Vinohrady, Charles University, Prague, Czech Republic., Schmidt B; Cardioangiologisches Centrum Bethanien, Agaplesion Markus Krankenhaus, Frankfurt, Germany., Landmesser U; Department of Cardiology, Angiology, and Intensive Care Medicine, Deutsches Herzzentrum Charité, Charité University Medicine, Berlin., Döhner W; Berlin Institute of Health-Center for Regenerative Therapies, Berlin, Germany.; Deutsches Herzzentrum der Charité, Campus Virchow Klinikum, Berlin, Germany.; German Centre for Cardiovascular Research (DZHK)- partner site Berlin, Charité Universitätsmedizin, Berlin, Germany., Hindricks G; German Heart Center Charite, Campus Mitte, Berlin, Germany., Kovac J; Leicester NIHR BRU, University of Leicester, Glenfield Hospital, Leicester, UK., Camm AJ; Genetic and Cardiovascular Sciences Institute, Cardiology Academic Group, St. George's University of London, Cranmer Terrace, London SW190RE, UK.
Jazyk:	angličtina
Zdroj:	Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology [Europace] 2024 Mar 30; Vol. 26 (4).
DOI:	10.1093/europace/euae035
Abstrakt:	A significant proportion of patients who suffer from atrial fibrillation (AF) and are in need of thromboembolic protection are not treated with oral anticoagulation or discontinue this treatment shortly after its initiation. This undertreatment has not improved sufficiently despite the availability of direct oral anticoagulants which are associated with less major bleeding than vitamin K antagonists. Multiple reasons account for this, including bleeding events or ischaemic strokes whilst on anticoagulation, a serious risk of bleeding events, poor treatment compliance despite best educational attempts, or aversion to drug therapy. An alternative interventional therapy, which is not associated with long-term bleeding and is as effective as vitamin K anticoagulation, was introduced over 20 years ago. Because of significant improvements in procedural safety over the years, left atrial appendage closure, predominantly achieved using a catheter-based, device implantation approach, is increasingly favoured for the prevention of thromboembolic events in patients who cannot achieve effective anticoagulation. This management strategy is well known to the interventional cardiologist/electrophysiologist but is not more widely appreciated within cardiology or internal medicine. This article introduces the devices and briefly explains the implantation technique. The indications and device follow-up are more comprehensively described. Almost all physicians who care for adult patients will have many with AF. This practical guide, written within guideline/guidance boundaries, is aimed at those non-implanting physicians who may need to refer patients for consideration of this new therapy, which is becoming increasingly popular. Competing Interests: Conflict of interest: C.B.: none declared. R.B.: personal fees from Bayer, Bristol-Myers Squibb, LEO-Pharma, Pfizer, VIATRIS, and research support by the Bavarian State Ministry of Health; CPC University of Colorado; FADOI, Italy. S.Be.: proctor and speaker fees from Boston Scientific, Edwards, Abbott, fees go to the department. S.Bi.: none declared. L.V.A.B.: consultant for Medtronic, Boston Scientific, Adagio, and ACUTUS, fees go to the department. G.B.: speaker fees from Bayer, Boehringer Ingelheim, Boston Scientific, Daiichi-Sankyo, Janssen, and Sanofi. S.Bo.: Consultant for Medtronic, Boston Scientific, Microport, and Zoll. A.J.C.: personal fees from Abbott, Boston Scientific, Medtronic, Pfizer/BMS, Daiichi Sankyo, Bayer and Sanofi. T.D.P.: no personal disclosures to report. Consultancy activity for Boston Scientific, invoiced through institutional research fund. W.D.: consulting and speaker fees from Ai Mediq, Bayer, Boehringer Ingelheim, Medtronic, Boston Scientific, Vifor Pharma; travel support from Pharmacosmos; research support from EU (Horizon2020), German Ministry of Education and Research, German Center for Cardiovascular Research, Vifor Pharma. S.G.: consulting and speaker fees from Boston Scientific. M.G.: Advisory Board Member for Boston Scientific; proctor for Boston Scientific, Abbott; fees for lectures and travel grants: from Boston Scientific, Abbott, Occlutech, Pfizer. K.G.H.: speaker’s honoraria, consulting fees, lecture honoraria and/or study grants from Abbott, Amarin; Alexion, AstraZeneca, Bayer Healthcare, Biotronik, Boehringer Ingelheim, Boston Scientific, Bristol-Myers Squibb, Daiichi-Sankyo, Edwards Lifesciences, Medtronic, Novartis, Pfizer, Portola, Premier Research, Sanofi, SUN Pharma, and W.L. Gore and Associates. J.E.N.-K.: consultant to Boston Scientific, Medtronic, Edwards Lifesciences, Picardia, Venus Medtech, speaker for Abbott. U.L.: research grant to institution from Abbott, Bayer, speaker or consulting honorary from Abbott, Boston Scientific, Bayer; Pfizer, Daiichi-Sankyo. G.Y.H.L.: consultant and speaker for BMS/Pfizer, Boehringer Ingelheim, Daiichi-Sankyo, Anthos. No fees are received personally. National Institute for Health and Care Research (NIHR) Senior Investigator and co-principal investigator of the AFFIRMO project on multi-morbidity in AF, funded from the European Union's Horizon 2020 research and innovation programme under grant agreement no. 899871. J.E.N.-K.: research grants from Abbott, Boston Scientific, Novo Nordic Foundation. J.E.N.-K.: research grants from Abbott, Boston Scientific, Novo Nordic Foundation. E.M.: research grants from Abbott, Biotronik, Boston Scientific, Medtronic, MicroPort, and Zoll. Consultant and speaker fees from Abbott, Abbott, Medtronic, and Zoll. J.E.N.-K.: research grants from Abbott, Boston Scientific, Novo Nordic Foundation. P.O.: speaking honoraria from Bayer, Abbott, Boston Scientific. T.P.: none declared. B.S.: consultant and speaker for Bostin Scientific, Abbott, Medtronic, Biosense Webster. M.S.: none declared. R.B.S. has received funding from the European Research Council (ERC) under the European Union's Horizon 2020 research and innovation programme under the grant agreement no. 648131, from the European Union's Horizon 2020 research and innovation programme under the grant agreement no. 847770 (AFFECT-EU) and German Center for Cardiovascular Research (DZHK e.V.) (81Z1710103 and 81Z0710114); German Ministry of Research and Education (BMBF 01ZX1408A) and ERACoSysMed3 (031L0239); Wolfgang Seefried project funding German Heart Foundation; lecture fees and advisory board fees from BMS/Pfizer and Novartis outside this work. C.T.: advisory board member of Boston Scientific; proctor for Boston Scientific and Abbott; fees for lectures and travel grants from Boston Scientific and Abbott. A portion of the fees goes to the institute. A.T.: consultant and proctor for Abbott, consultant for Boston Scientific and Pie Medical. (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)
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