Stroke prevention is the primary goal of therapy in patients with atrial fibrillation (AF).
1
Heart has published numerous papers on early AF detection,
2
approaches for restoring normal sinus rhythm, risk scores for determining which AF patients benefit most from anti-thrombotic therapy, and transcatheter occlusion of the left atrial appendage (LAA) to prevent thrombus formation.
3–6
Early studies of LAA occlusion compared this procedure to vitamin K antagonist (VKA) therapy for stroke prevention. Now, direct oral anticoagulants (DOACs) have replaced VKA therapy in many AF patients due to an improved risk/benefit profile, among other advantages, but LAA occlusion has not been compared to DOAC therapy.
In this issue of Heart, Sahay and colleagues (see
page 139
) performed a network meta-analysis of the efficacy and safety of LAA occlusion compared to medical therapy based on 19 randomized trials...