Date of Award

Spring 2026

Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)

Department

Physician Assistant Studies

First Advisor

Jay Metzger

Keywords

atrial fibrillation, oral anticoagulation, left atrial appendage closure, DOAC, Warfarin, Watchman device, and Amplatzer Amulet

Abstract

Atrial fibrillation is a common chronic medical condition that affects the heart. Individuals with atrial fibrillation and a CHA2DS2-VASc score greater than zero in men and one in women are at an increased risk of thrombus formation due to the stasis of blood flow in the chambers of the heart. The most common area of the heart where thrombi form is the left atrial appendage. To mitigate this risk, individuals are prescribed an oral anticoagulant medication as a first-line treatment. In recent years, a procedure that closes off the left atrial appendage has been introduced as an additional way to decrease the risk of thrombus formation. The purpose of this literature review is to investigate whether all-cause mortality is reduced with the use of a left atrial appendage closure compared to oral anticoagulation in those with atrial fibrillation. The electronic databases PubMed and Embase were searched, and the eight studies included in this review were randomized controlled trials and clinical studies within the last five years. Current research shows that left atrial appendage closure is noninferior compared to oral anticoagulation in terms of mortality prevention. Future research needs to be conducted to assess whether the left atrial appendage closure could be used as a first-line treatment for thrombus prevention in those with atrial fibrillation.

Comments

Note: this is a corrected draft of the student work, not the final version

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