SCAI, ACC and HRS Release Expert Consensus on Left Atrial Appendage Institutional and Operator Requirements

WASHINGTON, Dec. 10, 2015 /PRNewswire/ -- Recommendations to institutions and interested physicians for the establishment and maintenance of left atrial appendage occlusion (LAAO) programs performing LAA closure (LAAC) was published today. The Society for Cardiovascular Angiography and Interventions (SCAI), the American College of Cardiology (ACC) and the Heart Rhythm Society (HRS) published the recommendations in the document titled, "SCAI/ACC/HRS Institutional and Operator Requirements for Left Atrial Appendage Occlusion," in Catheterization and Cardiovascular Interventions (CCI), Journal of the American College of Cardiology (JACC) and HeartRhythm Journal.

LAAO is providing a new transcatheter treatment option for patients at risk for stroke who cannot be treated long-term with anticoagulation medications.  Atrial fibrillation (AF) is an irregular heartbeat caused by an abnormal heart rhythm that makes the heart's upper chambers quiver. During an AF episode, blood can collect inside the small portion of the heart known as the LAA. If a blood clot escapes from the LAA, it can travel to the brain and cause a stroke. Anticoagulant medications such as warfarin are the standard of care for most AF patients but are associated with an increased risk of bleeding. As a result, treatment has been developed to close the LAA for those who are unable to take anticoagulants on a long-term basis.

The expert consensus paper was developed by a committee of interventional cardiologists and electrophysiologists to help physicians and hospitals offer consistent and appropriate care to AF patients treated with LAAC to reduce their stroke risk.

"Through our collaboration, SCAI, the ACC and HRS have brought together combined experience in LAA closure to produce a document that will set the standard for safe and effective implementation of this technology to fulfill an important unmet need in treating patients with AF who are at risk for stroke," said Clifford J. Kavinsky, MD, PhD, FSCAI, lead author of the document and director of the Center for Adult Structural Heart Disease at Rush University Medical Center in Chicago.

In the paper released today, the committee recommends physicians performing LAAC procedures have significant knowledge of AF, including medical management, rate and rhythm control, tools for assessing stroke risk, management of oral anticoagulant therapy, knowledge of available medications, an understanding of bleeding risks, and knowledge of risks associated with LAAC. The document also recommends physicians have a detailed understanding of the left atrium and LAA, and experience with procedures requiring access to the left side of the heart.

Institutions performing LAAC procedures should perform at least 50 structural heart disease or left-sided catheter ablations, with at least 25 involving transseptal puncture through an intact septum in the year prior to starting a LAAC program. Procedures should be performed in a cardiac catheterization laboratory, electrophysiology suite or hybrid suite, with quality imaging available.

The document also stresses the importance of continuing to collect data on these procedures as the number of devices and approaches to minimally invasive LAAC expands in the coming years. Participation in a national registry should be mandatory, according to the committee, and individual institutions should establish processes to regularly review aggregate and physician-specific results, including number of implants, complications and outcomes.

"This document will ensure that institutions and operators developing LAA occlusion programs will have the necessary experience, training and infrastructure to carry out this procedure in a way that optimizes patient outcomes," Kavinsky continued.

On Thursday, Dec. 10, 2015, shortly after the publication of this document, SCAI, the ACC and HRS will be submitting a multi-specialty comment letter to the Centers for Medicaid & Medicare Services regarding the recent draft National Coverage Determination for LAAO.

About SCAI
The Society for Cardiovascular Angiography and Interventions is a 4,500-member professional organization representing invasive and interventional cardiologists in approximately 70 nations. SCAI's mission is to promote excellence in invasive/interventional cardiovascular medicine through physician education and representation, and advancement of quality standards to enhance patient care. SCAI's public education program, Seconds Count, offers comprehensive information about cardiovascular disease. For more information about SCAI and Seconds Count, visit www.SCAI.org or www.SecondsCount.org. Follow @SCAI and @SCAINews on Twitter for the latest heart health news.

About the ACC
The American College of Cardiology is a 49,000-member medical society that serves as the professional home for the entire cardiovascular care team. The mission of the College is to transform cardiovascular care and to improve heart health. The ACC leads in the formation of health policy, clinical standards and practice guidelines. The College operates national registries to measure and improve care. It also provides professional medical education, disseminates cardiovascular research and bestows credentials upon cardiovascular specialists who meet stringent qualifications. For more information, visit www.acc.org.

About HRS
The Heart Rhythm Society is the international leader in science, education and advocacy for cardiac arrhythmia professionals and patients, and the primary information resource on heart rhythm disorders. Its mission is to improve the care of patients by promoting research, education and optimal health care policies and standards. Incorporated in 1979 and based in Washington, DC, it has a membership of more than 5,800 heart rhythm professionals in more than 72 countries around the world. For more information, visit www.HRSonline.org.

Contacts:
SCAI: Kimberly Brown, 202-644-8561, [email protected]
ACC: Beth Casteel, 202-375-6275, [email protected] 
HRS: Allison Kassel, 703-739-8362, [email protected]  

SOURCE SCAI

Related Links

http://www.SCAI.org