Incidence Of Left Atrial/left Atrial Appendage Thrombosis In Patients With Non Valvular Atrial Fibrillation And Its Anticoagulant Therapy Evaluation Of Efficacy And Safety:A Meta-analysis

Objective:To determine the incidence and influencing factors of left atrial/left atrial appendage thrombus(LAT/LAAT)diagnosed by transesophageal echocardiography(TEE)before radiofrequency ablation or electrocardioversion,and to evaluate the efficacy and safety of warfarin and new oral anticoagulants on LAT/ LAAT,so as to provide reference for clinical anticoagulation treatment.Methods:The relevant documents from January 1990 to February 2020 in Pub Med,MEDLINE,CNKI,Wanfang database knowledge service platform and VIP journal database were searched by computer.According to the inclusion criteria and exclusion criteria,complete the literature selection and data sorting,and use Review Manager 5.3 software for data processing.Results:According to the inclusion criteria,23 studies and 10580 patients were included in the study.The analysis results of 16 studies are as follows: 1.the incidence of LAT / LAAT was included in 16 studies,10235 patients were included,and anticoagulants were taken orally for at least 4 weeks before operation,with the incidence of 2%(95% CI: 1%-4%);2.the impact of AF category on the incidence of LA /LAA was included in 9344 patients,including 5333 patients with paroxysmal AF and 4011 patients with persistent AF,results:or = 0.28,95% CI: 0.2-0.4,P < 0.0001,I2 = 0%,the difference was statistically significant;3.the effect of warfarin and noacs on the incidence of LAT/ LAAT before operation: 5075 patients were included,2315 of them were warfarin,2760 were noacs,results: or = 1.64,95% CI: 0.84-3.18,P = 0.15,I2 = 55%,the difference was not statistically significant.The results of 7 studies are as follows: 1.the efficacy of warfarin and noacs in the treatment of LAT / LAAT was analyzed in 276 patients,The results suggest that the atrial fibrillation of LAT / LAAT patient oral anticoagulant 2-January post-thrombosis rate was 67.3%,of which VKA65.5%,NOCS68.4%,P <0.001,and differences were statistically significant;subgroup analysis The thrombus solubility ratio of Dabadosa and Lviva’s Lviva is 74.7%and 74.6%,respectively.2.Lat/LAAT anticoagulant is relatively safe,and there is less probability that the incidents such as stroke,transient cerebral cerebral ischemia attacks and bleeding.Conclusion:1.Radio frequency ablation or precondensity treatment of radiocogerative treatment of electrolyoraity for 3-4 weeks of travel is 2%,and the thrombus solubility is 67.3%;2.2.Jingjing treatment,persistent atrial fibrillation The habitual atrial fibrillation is more likely to occur lat / lat,and there is no significant difference in the formation of NOCS and Warfill on thrombosis;3.3.The new oral anti-intensive drug can replace Hua Farlin.