Edgar Tay1, Biswajit Paul2, Jason Sharp3, Dennis Wang3, Angus Shing Fung Chui4, Prakash Kumar Hazra2, Teguh Santoso5, Bert Albers6, Hans-Christoph Diener7, Thorsten Lewalter8, Andrew Wong9. 1. NUHS Tower Block, Level 9 Cardiac Department, National University Hospital, National University Heart Centre Singapore, 1E Kent Ridge Road, Singapore, 119228, Singapore. edgartay1@gmail.com. 2. AMRI Hospitals, Kolkata, India. 3. Specialist Cardiology, Wahroonga, Australia. 4. Queen Elizabeth Hospital, Hong Kong, Hong Kong. 5. Medistra Hospital, Jakarta, Indonesia. 6. Albers Clinical Evidence Consultancy, Woold, Winterswijk, The Netherlands. 7. Faculty of Medicine, University Duisburg-Essen, Essen, Germany. 8. Peter Osypka Heart Center, Munich, Germany. 9. Royal Brisbane and Women's Hospital and University of Queensland, Brisbane, Australia.
Abstract
PURPOSE: To develop a consensus statement for left atrial appendage occlusion (LAAO) in Asian-Pacific patients with non-valvular atrial fibrillation (NVAF) at risk of ischemic stroke. The need for such a region-specific consensus was indicated by the relative paucity of clinical evidence for LAAO and oral anticoagulation therapy obtained in Asian-Pacific populations and the specific stroke and bleeding characteristics of this population. METHODS: Consensus was developed by discussion and evaluation of available evidence and expert opinions during a 2-day meeting attended by clinical experts from the Asian-Pacific regions. RESULTS: The consensus statement arrived at provides recommendations based on available evidence and expert opinions regarding LAAO in Asian-Pacific patients. Gaps in the evidence and other areas requiring further research were identified. CONCLUSION: LAAO is an alternative device-based therapy in carefully selected patients with NVAF at risk of ischemic stroke. However, evidence for LAAO is primarily obtained from Caucasian populations, and data on LAAO in Asian-Pacific patients are scarce. While the present consensus statement addresses several therapy-related aspects based on careful interpretation of available evidence and expert opinions, other areas require additional evidence derived from Asian-Pacific populations.
PURPOSE: To develop a consensus statement for left atrial appendage occlusion (LAAO) in Asian-Pacific patients with non-valvular atrial fibrillation (NVAF) at risk of ischemic stroke. The need for such a region-specific consensus was indicated by the relative paucity of clinical evidence for LAAO and oral anticoagulation therapy obtained in Asian-Pacific populations and the specific stroke and bleeding characteristics of this population. METHODS: Consensus was developed by discussion and evaluation of available evidence and expert opinions during a 2-day meeting attended by clinical experts from the Asian-Pacific regions. RESULTS: The consensus statement arrived at provides recommendations based on available evidence and expert opinions regarding LAAO in Asian-Pacific patients. Gaps in the evidence and other areas requiring further research were identified. CONCLUSION:LAAO is an alternative device-based therapy in carefully selected patients with NVAF at risk of ischemic stroke. However, evidence for LAAO is primarily obtained from Caucasian populations, and data on LAAO in Asian-Pacific patients are scarce. While the present consensus statement addresses several therapy-related aspects based on careful interpretation of available evidence and expert opinions, other areas require additional evidence derived from Asian-Pacific populations.
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