临床荟萃 ›› 2016, Vol. 31 ›› Issue (1): 10-13.doi: 10.3969/j.issn.1004-583X.2016.01.003

• 专题 • 上一篇    下一篇

左心耳封堵在非瓣膜性心房颤动卒中的预防作用

齐淑媛, 田颖   

  1. 首都医科大学附属北京朝阳医院心脏中心/心律失常科,北京 100020
  • 收稿日期:2015-10-14 出版日期:2016-01-05 发布日期:2016-04-19
  • 通讯作者: 田颖,Email:doctorty2000@163.com
  • 作者简介:田颖,医学博士后,副主任医师,首都医科大学附属北京朝阳医院房颤中心副主任。兼任:中国医师协会心律专业委员会青年委员会,副主任委员; 中华医学会心电生理和起搏分会青年委员会,委员;中国生物医学工程学会 心律学会青年委员会,委员;北京医学会心电生理与起搏分会青年委员会,副主任委员;中华医学会心电生理和起搏分会第六届委员会电生理女医师联盟,委员;中国医师协会心律专业委员会 女医师专业委员会,委员;北京心律失常联盟(AA联盟),委员。
  • 基金资助:
    国家自然科学基金资助项目(81470023,81100125,81307293)

Role of percutaneous left atrial appendage occlusion in stroke prevention for nonvalvular atrial fibrillation

Qi Shuyuan,Tian Ying   

  1. Center for Arrhythmia, Heart Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
  • Received:2015-10-14 Online:2016-01-05 Published:2016-04-19
  • Contact: Tian Ying, Email: doctorty2000@163.com

摘要: 血栓栓塞事件是心房颤动(房颤)最严重的并发症,及早识别并预防其栓塞风险至关重要。传统的抗凝治疗在预防非瓣膜性房颤患者的血栓栓塞事件方面存在一定局限性。左心耳部被证实为房颤患者血栓形成的主要部位,这一发现促使了经皮左心耳封堵技术的迅速发展。与抗凝药物相比,经皮左心耳封堵术可有效降低房颤患者血栓栓塞事件的发生率,且适用于抗凝禁忌的房颤患者。目前,WATCHMAN与ACP封堵装置已被授权进入欧盟市场,LARIAT左心耳结扎装置也因其有效性及安全性被美国FDA批准应用。经皮左心耳封堵及结扎术的适应证广,安全性高,有望成为多数房颤患者预防血栓栓塞事件的选择。

关键词: 心房颤动, 血栓栓塞, 左心耳封堵

Abstract: Thromboembolism is the most serious complication in patients with atrial fibrillation(AF).It is crucial to predict and reduce the thromboembolic risk as soon as possible.Chronic anticoagulaion therapy has certain limitations in the prevention of thromboembolic events.Left atrial appendage(LAA) was confirmed as the main part of thrombus formation in patients with nonvalvular AF.As a result,percutaneous LAA occlusion has been advocated as a strategy for the prevention of thromboembolic event.LAA occlusion can effectively reduce the incidence of thromboembolic events in patients with nonvalvular AF and was also considered for patients with contraindications to oral anticoagulation.The WATCHMAN and ACP device have been authorized to enter the European Union market.LARIAT ligation device was also approved by US Food and Drug Administration because of its efficacy and safety.Due to its wide indications and high safety,percutaneous LAA occlusion or suture ligation is expected to become a reasonable alternative to prevent thromboembolic events for most patients with AF.

Key words: atrial fibrillation, thromboembolism, percutaneous left atrial appendage transcatheter occlusion

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