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According to a study published in Cardiovascular Intervention and Therapeutics, the safety and efficacy profiles of <a href="https://www.docwirenews.com/condition-center/combined-therapy-of-catheter-ablation-and-left-atrial-appendage-closure-for-patients-with-atrial-fibrillation-a-case-control-study/">left atrial appendage closure devices</a> (LAAC) in patients with atrial fibrillation (AFib) are lacking research. Investigators, led by Keiichi Takeda, examined all-cause mortality, stroke, major bleeding, medications, and device-related thrombus (DRT) in patients with AFib managed with a <a href="https://www.docwirenews.com/condition-center/left-atrial-appendage-closure-for-patients-with-cerebral-amyloid-angiopathy-and-atrial-fibrillation-the-laa-caa-cohort/">LAAC device</a> and direct oral anticoagulants (DOACs).
According to their report, &#8220;the incidence of all-cause mortality, stroke, and major bleeding were similar between LAAC devices and DOACs.&#8221; Furthermore, Takeda and colleagues stated that &#8220;the rate of complications was acceptable, and those of DRT were lower than the average incidence reported in previous studies.
The study&#8217;s collaborators reviewed eight studies on LAAC devices (WATCHMAN and Amulet) and three studies on a DOAC (rivaroxaban), encompassing a total of 24,055 patients with AFib. Among the cohort, 2,855 patients had <a href="https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/left-atrial-appendage-closure-procedures">LAAC devices</a>, and 21,200 were treated with DOACs.
The researchers reported the following pooled incidences of the primary outcomes per person-years. All-cause mortality was 0.06 for WATCHMAN (95% confidence interval [CI], 0.02–0.10), 0.04 for Amulet (95% CI, 0.00–0.14), and 0.03 for rivaroxaban (95% CI 0.01–0.04). The incidence of stroke was 0.02 for WATCHMAN (95% CI, 0.00–0.04), 0 for Amulet, and 0.01 for rivaroxaban (95% CI, 0.01–0.2). Incidences of major bleeding were 0.04 (95% CI, 0.02–0.06), 0.02 (95% CI, 0.00–0.06), and 0.02 (95% CI, 0.01–0.03) for WATCHMAN, Amulet, and rivaroxaban, respectively. Further, the incidence rate of DRT was 2.3%, and complications were reported in 9% of patients.
The investigators acknowledged that follow-up research was needed, but ultimately concluded that &#8220;concomitant anticoagulant and antiplatelet therapies should be further evaluated to find the optimal regimen regiment for AFib patients with LAAC devices.&#8221;

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Left Atrial Appendage Closure Devices and Direct Oral Anticoagulants in Atrial Fibrillation

Atrial Fibrillation

According to a study published in Cardiovascular Intervention and Therapeutics, the safety and efficacy profiles of left atrial appendage closure devices (LAAC) in patients ...

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