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左心耳封堵预防心房颤动患者血栓栓塞事件

Left atrial appendage closure for the prevention of thromboembolism in patients with atrial fibrillation

摘要:

目的 在非瓣膜病心房颤动(房颤)患者中,血栓栓塞事件与左心耳血栓相关.观察经皮左心耳封堵在预防房颤患者血栓栓塞事件中的有效性和安全性.方法 研究纳入2014年3月至2016年3月阜外医院单一病房的CHADS2评分≥1分的成年非瓣膜病房颤患者予以经皮左心耳植入术,并于术后1、3、6、12个月定期行超声心动图检查随访.有效性主要终点为脑卒中、心血管死亡、以及体循环栓塞的复合终点.安全性主要终点为大出血、心脏压塞、器械栓塞.结果 研究共纳入30例左心耳封堵患者,3例患者退出研究.随访6.3个月.有效性主要终点发生率为0,安全性主要终点发生率为7.7%.结论 左心耳封堵器植入可以安全有效地预防非瓣膜病房颤患者血栓栓塞事件的发生.

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abstracts:

Objective In patients with non-valvular atrial fibrillation,embolic stroke is thought to be associated with left atrial appendage (LAA)thrombi.We assessed the efficacy and safety of percutaneous closure of the LAA for prevention of stroke in patients with atrial fibrillation.Methods Adult patients with non-valvular atrial fibrillation and CHADS2 score ≥ 1 were eligible for inclusion from March 2014 to March 2016.Patients enrolled were undergone percutaneous left atrial appendage closure,and followed up with echocardiogram at 1,3,6 and 12 months after procedure.Efficacy was assessed by a primary composite endpoint of stroke,cardiovascular death,and systemic embolism.Serious adverse events that contituted the primary endpoint for safety included major bleeding,pericardial effusion,and device embolization.Results Thirty patients were enrolled for left atrial appendage closure.Three patients quit the study.At the follow-up of 190 patient-months (6.3months),Efficacy end point happened with 0 per 100 patient-months.Safety end point happened with 0.5/100 patient-months.Conclusion percutaneous left atrial appendage closure was an effective and safe method for the prevention of stroke in atrial fibrillation patients.

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