Oral Anticoagulants : Oral anticoagulants(OA), also known as blood thinners, are commonly used to prevent blood clots in adults. They are typically used for both short-term and long-term treatment. Recently, there has been increasing interest in using oral anticoagulants in children as well. The increased use of oral anticoagulants is due to their ease of use, favorable pharmacokinetics, decreased drug-drug interactions, and lack of monitoring requirements. While routine laboratory monitoring is not recommended for oral anticoagulants, it is possible and will be discussed later for each drug. Oral anticoagulation has been very effective in treating non-valvular atrial fibrillation (Afib), a type of irregular heartbeat.
Left Atrial Appendage Occlusion: Left atrial appendage occlusion (LAAO) is a procedure that has been introduced as an alternative to traditional blood thinners for the prevention of stroke in patients with atrial fibrillation (AF) who are unable to take warfarin or novel oral anticoagulants (NOACs). LAAO involves closing off the left atrial appendage (LAA), a small pouch in the upper left chamber of the heart that is a common source of blood clots that can lead to stroke. LAAO is a procedure that closes off a small pouch in the heart to prevent stroke in AF patients who cannot take blood thinners.
Ultimately, the best choice depends on individual circumstances.
Factors to consider include:
- Stroke risk: Patients with high stroke risk may benefit more from LAAO.
- Bleeding risk: Patients with a high risk of bleeding may be better suited for OAC.
- Patient preference: Some patients may prefer avoiding long-term medication and opt for LAAO.
The discussion is ongoing, with new research emerging constantly. Current evidence suggests that LAAO may be slightly more effective than OAC in preventing stroke, but with a small edge. OAC remains a viable option with lower invasiveness and longer-term data.