Percutaneous atrial appendage occlusion for stroke prevention in patients with atrial fibrillation: a systematic review

Heart. 2012 Jun;98(12):900-7. doi: 10.1136/heartjnl-2011-301256. Epub 2012 Apr 17.

Abstract

This review aims to evaluate systematically the safety and efficacy of percutaneous left atrial appendage occlusion (PLAAO) in stroke prevention for patients with atrial fibrillation (AF). A systematic review of peer-reviewed journals on PLAAO before June 2011 was performed on three electronic databases. Fourteen studies were identified for evaluation. Overall, implantation was successful in 93% of all cases. Periprocedural mortality and stroke rates were 1.1% and 0.6%, respectively. The incidences of pericardial effusion/cardiac tamponade and device embolisation were 4% and 0.7%, respectively. At the time of the latest follow-up (up to 40 months), the overall incidence of stroke among all studies was 1.4% per annum. Existing evidence suggests that PLAAO is a relatively safe treatment for patients with AF. However, there is a need for further evaluation of its efficacy in the form of large and well-designed randomised controlled trials.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Atrial Appendage*
  • Atrial Fibrillation / complications
  • Atrial Fibrillation / diagnosis
  • Atrial Fibrillation / therapy*
  • Cardiac Catheterization / methods*
  • Echocardiography, Transesophageal
  • Embolization, Therapeutic / methods*
  • Humans
  • Incidence
  • Stroke / epidemiology
  • Stroke / etiology
  • Stroke / prevention & control*
  • Treatment Outcome