In Defense of Left Atrial Appendage Closure - Dr. Vivek Reddy
(The above link, allows access to the article discussed below: In Defense of Left Atrial Appendage Closure by Dr Vivek Reddy, with only a simply free registration of your email address and username)
Hi All,
The above linked excellent article in Medscape by well-known and highly-regarded AFIB ablation EP and researcher Dr. Vivek Reddy at Mount Sinai Medical Center in New York City, provides a spot-on, well-needed tonic and corrective treatment to what, in my view and that of many front-line experts in the growing sub-field of LAA Closure research, was another well-intentioned yet shorted-sighted analysis of the state of LAA Closure for stroke and bleeding reduction reflected in Dr Mandrola's assessment of the Watchman device. As such, I feel Dr Mandrola used a too narrow view of the first two randomized clinical trials in PROTECT-AF and PREVAIL, mostly by looking at the data and drawing his negative conclusion about LAA Closure with the Watchman device too much in the rear-view mirror and while overlooking key points and insights that the collective experience with the Watchman and other LAA Closure systems now strongly suggest as of late 2016.
It is midnight as I write this note on my Iphone so I'm shutting off the light for dreamland now. When time allows I hope to finish my own look at the state of LAA Closure in light of the comments by Dr Mandrola in his Medscape column a few weeks ago, and posted in a thread below, that I want to share from an Afibbers patient perspective, especially with those on our forum for whom LAA may well be of relevant interest.
In the meantime, please read this super analysis by Dr Reddy whose timing in writing his article brought a smile to my face as it makes my summary of the same issues much easier and requiring less grunt work at the keyboard than it would have demanded before I read Dr Reddy's cogent reply to Dr Mandrola's controversial and dismissive LAA-Closure comments.
Last week I had a head's up that such a thorough reply would likely be forthcoming, allowing me to put my promised comments on the back burner until I had the chance to read this excellent technical clarification of the Watchman issue by Dr Reddy.
In my summary update, I will address some of the key patient-oriented questions around this issue of LAA Closure which will mainly be of interest to those who either cannont tolerate OAC drugs, and yet require anticaogulation for safety, or those who may have had ... or could be candidates in the near future for ... LAA isolation ablation which carries around a 60% chance of needing to either stay on OAC drugs indefinitely or go for an LAA Closure procedure. It is important to understand that, in any event, a large majority of afibbers will never have to address this issue one way or the other.
Cheers!
Shannon
Edited 12 time(s). Last edit at 12/20/2016 09:29AM by Shannon.
