Lectures

John Camm, UK vs Hans Christoph Diener, DEU    Debate: Are the new ESC guidelines are too strict for Left Atrial Appendage Occlusion? John Camm - Yes, they are too strict. There is a larger group that should benefit from LAA occlusion and it should be stronger recommended too!Hans Christoph Diener - No, the ESC guidelines are right; LAA occlusion Should be limited to OAC contraindicated patients!

New oral anticoagulants or NOACs, with  favorable results from large scale phase III clinical trials, represent a major advancement and expanded armamentarium in antithrombotic therapy. There are still limitations associated. Many patients in need of anticoagulant therapy for indications not studied in the clinical trials will not be eligible for treatment.  The focus on NOACs has shifted to the practical approach and management in real life.

Broad based review, starting with the basic stroke risk management scores to bleeding risk scores towards expert knowledge and additional diagnostics to help define individual bleeding risk

Contraindications to OAC: Which are the patients who cannot legitimately take anti-coagulants - who have adverse events and where it won't work."

The incidence of ICH has remained unchanged and prevention takes a higher priority, now that more patients are on OAC than before. The management of ICH involves admission to stroke units, BP lowering and reversal of OAC.

The dilemma: should we start, or should we not start anti-coagulation therapy in patients with a prior intracranial hemorrhage and with AF?

There are many things to be learned from PFO trails for stroke prevention in other stroke prevention trials, such as the LAA occlusion trials.

Expert Panel discussion on balancing stroke risk & bleeding risk in patients with Atrial Fibrillation

Expert Panel discussion on balancing stroke risk & bleeding risk in patients with Atrial Fibrillation. This includes a discussion on trials, knowledge gaps with a main focus on patients with an elevated bleeding risk.