Expert consensus on clinical pathway of transcatheter left atrial appendage closure in China(2025)
10.3969/j.issn.1004-8812.2025.01.002
- VernacularTitle:中国经导管左心耳封堵术临床路径专家共识(2025版)
- Author:
China Heart HOUSE
;
Yong-jian WU
;
Da-xin ZHOU
- Collective Name:Structural Heart Disease Group,Chinese College of Cardiovascular Physicians
- Publication Type:Journal Article
- Keywords:
Atrial fibrillation;
Left atrial appendage;
Closure;
Clinical pathway;
Expert consensus
- From:
Chinese Journal of Interventional Cardiology
2025;33(1):5-32
- CountryChina
- Language:Chinese
-
Abstract:
This consensus focuses on the transcatheter left atrial appendage closure(LAAC).In response to the growing number of patients with atrial fibrillation,advancements in LA AC technology,and evolving clinical needs,it has been updated by the Structural Heart Disease Professional Committee of the Cardiovascular Physicians Branch of the Chinese Medical Doctor Association.The incidence of atrial fibrillation is increasing with population aging,leading to elevated stroke risk.LAAC offers an effective preventive solution.The consensus provides a detailed overview of LAAC's developmental trajectory,including its pivotal role in the comprehensive management of atrial fibrillation,milestone events in China,and substantial evidence-based data.Regarding team composition,the consensus outlines the inclusion of multidisciplinary professionals with clearly defined roles.It precisely delineates indications as non-valvular atrial fibrillation patients with high stroke risk and qualifying scores in specific scenarios,while also listing contraindications.Methodological aspects are comprehensively addressed,encompassing imaging assessments(such as the roles and key considerations of TTE,TEE,and cardiac CTA),the operational protocols for various devices(the selection,implantation,evaluation,and adjustment for plug-and disc-type devices),and perioperative management.Potential perioperative complications,such as pericardial effusion,stroke,and device dislocation,are reviewed with analyses of their causes and corresponding management strategies.Postoperative antithrombotic treatment strategies are tailored to different stages(intensive,consolidation,and special cases),while detailed follow-up plans(timelines,methods,content,and outcome assessment)are provided.The consensus also explores surgical approach options,highlighting the features and applications of"one-stop"and simplified LAAC procedures.Looking ahead,it focuses on the expansion of the applicable population,technological improvements,device innovations,further advancement of combined treatment,and optimized medication strategies.This comprehensive,precise,and forward-looking guidance aims to enhance LAAC's clinical practice and development,fostering its standardization,precision,and continuous innovation.
