¿Es el fin de la anticoagulación con la oclusión percutánea de la orejuela izquierda en fibrilación auricular?
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Universidad Industrial de Santander
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Introducción: la fibrilación auricular es la arritmia más frecuente en la práctica médica. Se asocia con una alta morbimortalidad, incluyendo accidentes cerebrovasculares, insuficiencia cardíaca y disminución de la calidad de vida. Los nuevos anticoagulantes orales tienen un riesgo hemorrágico no despreciable, lo que implica un problema en aquellos pacientes con alto riesgo de sangrado. Es así como el cierre percutáneo de orejuela izquierda surge como una alternativa en el tratamiento de pacientes con fibrilación auricular no valvular y alto riesgo de eventos tromboembólicos o complicaciones hemorrágicas. Objetivo: realizar un artículo de revisión acerca de la fibrilación auricular y el control del riesgo embólico, haciendo énfasis en la problemática actual de la anticoagulación oral y el uso de dispositivos de cierre percutáneo de la orejuela izquierda. Materiales y métodos: se realizó una búsqueda sistemática de artículos científicos en diferentes bases de datos, utilizando palabras claves y descriptores médicos que trataran acerca de la fibrilación auricular y los métodos terapéuticos utilizados en prevención de accidentes cerebrovasculares. Resultados: en total fueron analizados 59 artículos y sus hallazgos sugieren que el cierre percutáneo de orejuela izquierda es una posible alternativa en el tratamiento de pacientes con fibrilación auricular no valvular. Conclusiones: el cierre percutáneo de orejuela izquierda es eficaz en la prevención de accidente cerebrovascular en pacientes con fibrilación auricular no valvular con la potencial ventaja de no necesitar el uso crónico de anticoagulantes. MÉD.UIS. 2014;27(3):69-76.
Introduction: atrial fibrillation is the most common arrhythmia in clinical practice. Is associated with a high morbidity and mortality, including stroke, heart failure, and decreased of quality of life. The new oral anticoagulants have a non-negligible hemorrhagic risk, which implies a problem in those patients with high risk bleeding. Is as well percutaneous left atrial appendage closure emerges as an alternative in the treatment of patients with non-valvular atrial fibrillation and thromboembolic high risk or bleeding complications. Objective: to conduct a review article about atrial fibrillation and embolic risk control, with emphasis on the current problems of oral anticoagulation and the use of percutaneous left atrial appendage closure devices. Materials and methods: a systematic search of scientific articles was conducted in different databases, using key words and medical descriptors dealing about atrial fibrillation and the therapeutic methods used in stroke prevention. Results: in total 59 scientific articles were analyzed and theirs findings suggest that the percutaneous left atrial appendage closure is a possible alternative in the treatment of patients with non-valvular atrial fibrillation. Conclusions: the percutaneous left atrial appendage closure is effective in the prevention of stroke in patients with non-valvular atrial fibrillation with the potential advantage of not needing the chronic use of anticoagulants. MÉD.UIS. 2014;27(3):69-76. Atrial Fibrillation. . Stroke. Disease Prevention.
Introduction: atrial fibrillation is the most common arrhythmia in clinical practice. Is associated with a high morbidity and mortality, including stroke, heart failure, and decreased of quality of life. The new oral anticoagulants have a non-negligible hemorrhagic risk, which implies a problem in those patients with high risk bleeding. Is as well percutaneous left atrial appendage closure emerges as an alternative in the treatment of patients with non-valvular atrial fibrillation and thromboembolic high risk or bleeding complications. Objective: to conduct a review article about atrial fibrillation and embolic risk control, with emphasis on the current problems of oral anticoagulation and the use of percutaneous left atrial appendage closure devices. Materials and methods: a systematic search of scientific articles was conducted in different databases, using key words and medical descriptors dealing about atrial fibrillation and the therapeutic methods used in stroke prevention. Results: in total 59 scientific articles were analyzed and theirs findings suggest that the percutaneous left atrial appendage closure is a possible alternative in the treatment of patients with non-valvular atrial fibrillation. Conclusions: the percutaneous left atrial appendage closure is effective in the prevention of stroke in patients with non-valvular atrial fibrillation with the potential advantage of not needing the chronic use of anticoagulants. MÉD.UIS. 2014;27(3):69-76. Atrial Fibrillation. . Stroke. Disease Prevention.
Keywords
Atrial Fibrillation, Secondary treatment, Stroke, Disease Prevention, Accidente cerebrovascular, Prevención de enfermedades, Fibrilación atrial, Tratamiento secundario