Combination of pulmonary vein isolation and left atrial appendage closure for non-valvular atrial fibrillation
https://doi.org/10.17802/2306-1278-2018-7-4S-86-93
Abstract
Atrial fibrillation might occur up to 2% of the general population, with a lifetime risk of 24% in persons > 40 years of age. Catheter ablation is increasingly being used to treat drug-refractory atrial fibrillation. The long-term efficacy of catheter ablation is disappointing, with success rates about 50%. Stroke is one of the major complications of atrial fibrillation because of atrial thrombus formation. The overall annual stroke risk is 5% in patients with atrial fibrillation, increasing up to 15% in high-risk patients. The left atrial appendage was the source of thrombi in >90% of the patients with non-valvular atrial fibrillation. Anticoagulation should be given to prevent thromboembolic events. However, anticoagulant therapy has several disadvantages, such as (major) bleedings, interactions with some dietary components and other medications, and a narrow therapeutic range. In addition, patients with atrial fibrillation, especially the elderly, have low compliance. Exclusion of the left atrial appendage from the systemic circulation could be an alternative. Thus, the combination of the left atrial appendage closure with the isolation of the pulmonary veins appears to be a rational method for the treatment of atrial fibrillation. This approach eliminates the need for anticoagulants and reduces the risk of stroke.
About the Authors
N. A. Kochergin
Federal State Budgetary Institution Research Institute for Complex Issues of Cardiovascular Diseases
Russian Federation
Competing Interests: Нет конфликта интересов
Russian Federation
Kochergin Nikita A. - PhD, research assistant at the Laboratory of Interventional Cardiology.
6, Sosnovy Blvd., Kemerovo, 650002, tel. +79089523235
Competing Interests: Нет конфликта интересов
V. I. Ganyukov
Federal State Budgetary Institution Research Institute for Complex Issues of Cardiovascular Diseases
Russian Federation
Competing Interests: Нет конфликта интересов
Russian Federation
Ganyukov Vladimir I. - PhD, Head of the Laboratory of Interventional Cardiology.
6, Sosnovy Blvd., Kemerovo, 650002
Competing Interests: Нет конфликта интересов
S. E. Mamchur
Federal State Budgetary Institution Research Institute for Complex Issues of Cardiovascular Diseases
Russian Federation
Competing Interests: Нет конфликта интересов
Russian Federation
Mamchur Sergey E. - PhD, Head of Cardiovascular Disease Diagnostics.
6, Sosnovy Blvd., Kemerovo, 650002
Competing Interests: Нет конфликта интересов
O. A. Trubnikova
Federal State Budgetary Institution Research Institute for Complex Issues of Cardiovascular Diseases
Russian Federation
Competing Interests: Нет конфликта интересов
Russian Federation
Trubnikova Olga A. - PhD, Head of the Laboratory of Neurovascular Pathology.
6, Sosnovy Blvd., Kemerovo, 650002
Competing Interests: Нет конфликта интересов
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Review
For citations:
Kochergin N.A., Ganyukov V.I., Mamchur S.E., Trubnikova O.A. Combination of pulmonary vein isolation and left atrial appendage closure for non-valvular atrial fibrillation. Complex Issues of Cardiovascular Diseases. 2018;7(4S):86-93. (In Russ.) https://doi.org/10.17802/2306-1278-2018-7-4S-86-93
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