Titlebook: Left Atrial Appendage Closure; Mechanical Approache Jacqueline Saw,Saibal Kar,Matthew J. Price Book 2016 Springer International Publishing

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2196-8969 e reduction of thromboembolism in patients with atrial fibriPercutaneous left atrial appendage (LAA) closure is an emerging technology for thromboembolic prevention in patients with atrial fibrillation (AF). The first human implantation of an LAA device occurred in 2001, and since then four devices

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Mechanistic Rationale for LAA Closure with AF and Stroke Preventioneduction of stroke, however, with limited systemic adverse events. This approach has particular attraction to the subgroup of patients at high risk of stroke as well as complications from systemic anticoagulation.

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Atrial Fibrillation and Stroke Epidemiologylated stroke is largely preventable. The incidence and prevalence of AF increases substantially with age. Further, a global trend in rising prevalence of AF has been demonstrated in recent decades. The epidemiology of atrial fibrillation and AF-related stroke is reviewed in detail in this chapter.

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The Use of Intracardiac Echocardiography (ICE) to Guide LAA Closure of the LAA ostium, landing zone, length, shape and number of lobes. It is also helpful to guide the transseptal puncture, sheath placement, device placement, and assess device stability, post-placement leak, and procedural complications [12, 17, 19].

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LAA Anatomyvertent instrumentation of pulmonary veins and LAA during atrial and transseptal procedures requires a fundamental understanding of the anatomy and spatial relationships of these structures, in order to successfully plan and perform these procedures and avoid significant complications.

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Amplatzer Cardiac Plug and Amulethe third commercial device manufactured specifically for endovascular LAA closure, and real-world experience to-date has shown good safety and clinical efficacy. The second-generation ACP device, Amulet, has just been re-launched. This paper reviews in-depth the device characteristics and procedural techniques of the ACP and Amulet devices.

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Book 2016e first human implantation of an LAA device occurred in 2001, and since then four devices have received CE mark approval. These devices are being widely used in Europe for LAA closure in patients who are poor candidates for long-term oral anticoagulation. In the US, the WATCHMAN device (Boston Scien

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Efficacy and Limitations of Warfarin and Novel Oral Anticoagulants with Atrial Fibrillationntithrombotic therapy. Oral anticoagulant therapy (OAC) is extremely effective for the prevention of SSE, and for most patients, the risk:benefit ratio for stroke vs. major hemorrhage favors the use of OAC. A series of randomized controlled trials (RCTs) showed a 64 % reduction in the risk of stroke