Results of a several-year multicenter study PRAGUE-17 led by the main researcher doc. P. Osmančík from IIIrd internal cardiology clinic od Faculty Hospital Královské Vinohrady and the Third Faculty of Medicine, Charles University, were published in the Journal of the American College of Cardiology (IF = 18). The AZV grant, which supported the study, was also proposed for the award of the Minister of Health. There are 3 randomized studies on that topic. Two of them are from the USA, comparing catheter occlusion with warfarin, and the third one, comparing occlusion with NOAKs, is Czech.
How did the study turn out? Patients with atrial fibrillation are at risk of a cardioembolizing event due to arrhythmia. The cause is the formation of a thrombus in the left atrial appendage and its embolization. Therefore, p.o. anticoagulant treatment. That was represented in the past by warfarin, in recent years it has been replaced by safer non-vitamin K anticoagulants (NOAK). A new non-pharmacological method of preventing a cardioembolic event is the catheter closure of the left atrial appendage, which, however, has never been compared in terms of effectiveness with treatment with modern NOAKs. The objective of this prospective, multicenter, randomized study was therefore to compare the two methods. Patients with atrial fibrillation were randomized to receive NOAK or catheter occlusion of the left atrial appendage. The catheter closure of the appendage provided the same benefit as NOAK treatment.
More about the study here.
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