心房颤动中的左心耳闭合或药物治疗。
Landmesser, U., Skurk, C., Kirchhof, P., Lewalter, T., Hartung, J., Rroku, A., Pieske, B., Brachmann, J., Akin, I., Jacobshagen, C., Meder, B., Zeiher, A., Anker, S.D., Thiele, H., Blankenberg, S., Massberg, S., Schunkert, H., Frey, N., Joost, A., . . . Eitel, I. (2026). Left Atrial Appendage Closure or Medical Therapy in Atrial Fibrillation.. N Engl J Med. https://doi.org/10.1056/NEJMoa2513310
Landmesser U, Skurk C, Kirchhof P, Lewalter T, Hartung J, Rroku A, et al. Left Atrial Appendage Closure or Medical Therapy in Atrial Fibrillation.. N Engl J Med. 2026; doi: 10.1056/NEJMoa2513310
Landmesser U, Skurk C, Kirchhof P, et al. Left Atrial Appendage Closure or Medical Therapy in Atrial Fibrillation.[J]. N Engl J Med. 2026. DOI: 10.1056/NEJMoa2513310.
@article{landmesser2026,
author = {Ulf Landmesser and Carsten Skurk and Paulus Kirchhof and Thorsten Lewalter and Johannes Hartung and Andi Rroku and Burkert Pieske and Johannes Brachmann and Ibrahim Akin and Claudius Jacobshagen and Benjamin Meder and Andreas Zeiher and Stefan D Anker and Holger Thiele and Stefan Blankenberg and Steffen Massberg and Heribert Schunkert and Norbert Frey and Alexander Joost and Martin Bergmann and Ralph Stephan von Bardeleben and Tim Friede and Marius Placzek and Anna Suling and Karl Georg Haeusler and Matthias Endres and Karl Wegscheider and Leif-Hendrik Boldt and Ingo Eitel},
title = {Left Atrial Appendage Closure or Medical Therapy in Atrial Fibrillation.},
journal = {N Engl J Med},
year = {2026},
doi = {10.1056/NEJMoa2513310},
note = {PMID: 41849741},
}
TY - JOUR AU - Ulf Landmesser AU - Carsten Skurk AU - Paulus Kirchhof AU - Thorsten Lewalter AU - Johannes Hartung AU - Andi Rroku AU - Burkert Pieske AU - Johannes Brachmann AU - Ibrahim Akin AU - Claudius Jacobshagen AU - Benjamin Meder AU - Andreas Zeiher AU - Stefan D Anker AU - Holger Thiele AU - Stefan Blankenberg AU - Steffen Massberg AU - Heribert Schunkert AU - Norbert Frey AU - Alexander Joost AU - Martin Bergmann AU - Ralph Stephan von Bardeleben AU - Tim Friede AU - Marius Placzek AU - Anna Suling AU - Karl Georg Haeusler AU - Matthias Endres AU - Karl Wegscheider AU - Leif-Hendrik Boldt AU - Ingo Eitel TI - Left Atrial Appendage Closure or Medical Therapy in Atrial Fibrillation. T2 - N Engl J Med PY - 2026 DO - 10.1056/NEJMoa2513310 AN - PMID:41849741 ER -
Catheter-based closure of the left atrial appendage is an alternative to oral anticoagulation for stroke prevention in patients with atrial fibrillation. The effectiveness of this strategy, as compared with physician-directed best medical care, in patients at high risk for stroke and bleeding is unknown. In this multicenter randomized trial conducted in Germany, we assigned patients with atrial fibrillation and a high risk of stroke and bleeding to undergo left atrial appendage closure or to receive physician-directed best medical care (including direct oral anticoagulants, if eligible). The primary end point, tested for noninferiority, was a composite of stroke (ischemic or hemorrhagic), systemic embolism, major bleeding, or cardiovascular or unexplained death, assessed in a time-to-event analysis. The noninferiority margin was a hazard ratio of 1.3. A total of 912 adult patients underwent randomization. The primary end-point analysis included 446 patients who were assigned to undergo left atrial appendage closure (device group) and 442 who were assigned to physician-directed best medical care (medical-therapy group). The mean (±SD) age was 77.9±7.1 years; 38.6% of the patients were women, the mean CHA Among patients with atrial fibrillation at high risk for stroke and bleeding, left atrial appendage closure was not noninferior to physician-directed best medical care with regard to a composite end point of stroke, systemic embolism, major bleeding, or cardiovascular or unexplained death. (Funded by the German Center for Cardiovascular Research; CLOSURE-AF ClinicalTrials.gov number, NCT03463317.).