| Objective:Atrial fibrillation is a very common arrhythmia,and one of the most serious complications is stroke.Oral anticoagulants are the most important method to prevent stroke caused by atrial fibrillation.However,warfarin,a vitamin K antagonist,can lead to increased risk of bleeding,regular monitoring of the international standardized ratio of thrombin(INR),narrow treatment window.Due to the high price,lack of effective antagonists and poor patient compliance,the new oral anticoagulants fail to achieve the desired effect in clinical application.With the development of medicine,percutaneous left auricular occlusion has been applied in the prevention of stroke in patients with nonvalvular atrial fibrillation.Due to the short application time,the safety and effectiveness of percutaneous left auricular occlusion has not been determined.To obtain relevant conclusions and evidence,this paper conducted a meta-analysis on the published effectiveness and safety of percutaneous left auricular occlusion in the prevention of stroke in patients with nonvalvular atrial fibrillation.Methods:PUBMED,EMBASE,Cochrane,wanfang database,cnki,China biomedical literature database and other databases were searched by computer.The literature related to the prevention of stroke by left auricular occlusion from the establishment of the database to 2018 was searched,and included studies must meet inclusion and exclusion criteria.Due to the lack of a randomized controlled experimental group,we first conducted a meta-analysis of single group event rates by retrieving the main endpoint events of each observational study,and then compared them with relevant data in the currently published large randomized controlled clinical trials to further analyze the safety and effectiveness of left auricular occlusion.Results:In a total of 28 clinical study,the statistics of 4905 cases of subjects,which successfully implanted in 4706 patients,199 cases of implant failure,failure rate4.06%,and surgery related complications(air,equipment embolism and bleeding,cardiac tamponade)accounted for 4.73%,after analysis of a single set of rate get left closure low incidence of postoperative stroke events,the complication rate is low.Conclusion:1.Percutaneous left atrial auricular occlusion has a significantly effective on the prevention of stroke in patients with nvaf,providing a new treatment scheme for the prevention of stroke in patients with nonvalvular atrial fibrillation.2.Meta analysis was performed on the relevant observational data at home and abroad regarding percutaneous left auricular occlusion,which was safe compared with the classic large-scale experimental study.3.In order to further confirm the effectiveness and safety of percutaneous left auricular occlusion in the prevention of stroke in patients with nvaf,more randomized controlled trials are needed in the future. |
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