Medscape: Left atrial appendage closure

[marcyh]

This might be of interest. It is approved by admin.

For AF, LAA Rivals Anticoagulants After Ablation

A left atrial appendage (LAA) closure device provides long-term thromboembolic protection that is equivalent to direct oral anticoagulants after ablation for atrial fibrillation (AF), along with a lower risk of bleeding, according to the multicenter, randomized OPTION trial.

Based on this trial, which is the first to compare LAA closure with oral anticoagulants for stroke prevention after ablation for AF, LAA closure should now be considered "an effective first-line option," said Oussama M. Wazni, MD, head of the electrophysiology section at the Cleveland Clinic...

medscape.com/viewarticle/af...

[Poochmom]

I had my LAA clipped when I had my MiniMaze in 2022. It reduces stroke risk by 97% with an atriclip and also some have AFib originate in the LAA and this eliminates that. No need for oral anticoagulants ever again for AFib.

[Jajarunner]

Yet EP John Mandola is dead against it (link to article on here recently). So difficult to know who to believe with so many conflicting opinions. I'd love to get off anticoagulants as they make my life a misery ..

[mhoam in reply to Jajarunner]

Hi,

I don't think John Mandola (sp?) is "dead against it" per se. He appears to be against its heavy promotion within the US system of healthcare when the Clinical trials are not conducted to proper standards. He is sceptical about the design of clinical trials and feels many in the US are "interpreted" incorrectly for financial reasons.

[DawnTX in reply to mhoam]

right now I would question the trials which is sad but big Pharma I don’t trust much anymore and I certainly would not have surgery questions unless it is a last.

there is of ablation, which is big I know this because of my incredible EP, not always the favorite of the hospital because he will not do them over and over again the odds of getting the right spot and it is just a tiny area usually is quite difficult like finding a needle in a haystack and yet they will continue to give them when there are other ways. A an ablation is a Band-Aid. Don’t let it fool you or excite you. They don’t fail if they work, but it’s hard to get the spot and you could have a new spot open just beside it. This is why the mini maze, etc., is being more successful. each time you have an ablation you also have scarring. I only had three and yet I had so much scar tissue when I changed one would not consider doing another ablation. Normally I would say doctors are good and listen to them, but I have seen people mention as many as a dozen ablations on this site. I question everything now I wish I could come to the defense of healthcare but right now things need to be cleaned up and yes, financial gain seems to take priority over everything and everyone. The hospitals not the doctors are behind this. The for them and pretty much must do as except they took an oath to do no harm and what is being done at times I believe is very harmful to us.

my other EP, not only messed up using a technique. He pioneered because he is from research and should stay there in my opinion, not working on people… His technique almost killed me when things started going bad. I could not get calls back from either him or his staff extremely sick and I waited much too long to find another doctor thankfully I was blessed. God took his hands. I am here because of it because my new doctor cares. He was just recently given a brand new position at another hospital another state and I have lost him, but I am so happy for him. He was made chief of a large university hospital in Florida. He is young and humble and incredible. He once told me that learning never ends. He believes quality of life, no matter what our age.

remember you only have one I almost lost mine and had gone into heart failure to the point where as my EP said neither my or I could continue and endure. my heart failure has reversed. FYI there are so many good doctors out there unfortunately money ties their hands and they are not even getting it half the time as bad as healthcare can be here. I will tell you I could make a phone call today and be in the office of an EP or most likely by afternoon without going to emergency. When it comes to procedures ask questions. When I changed I had tachycardia that remained roughly around 200 beats a minute no break I could not walk I could not stand without tears pain. For me the right thing was a pacemaker. I have no regrets I was able to get out of the wheelchair, leaving the hospital and get into the car by myself. No it’s not quite that simple there are ups and downs, but keep your mind open before you try something that is still being questioned. There have been a few devices that were being pushed that out not to be

[Jajarunner in reply to mhoam]

I agree. I should have been more nuanced in what I said. That's exactly what he said and I was being too flippant. I think much of the private health care systems are influenced by money rather than good care. I was offered two operations on my groin for a minor sports injury. I refused on the grounds it was too extreme since I am only JajaJogger! Turned out to be referred pain from a stiff back 😱😱😱😱. Never trusted them since. At least with our cash strapped NHS you only get what is required!! 🤣🤣🤣. Have a good day 😊