Atrial fibrillation (AF) is the most common cardiac arrhythmia affecting the population, with an estimated prevalence of about 2% in the general population. At the same time, stroke is the common morbidity associated, especially in the elderly, where one-third of strokes are attributed to atrial fibrillation.
In atrial fibrillation, the Left Atrial Appendage acts as a site of blood stasis that can significantly increase the risk of thrombogenesis and subsequent systemic embolization of a clot - commonly leading to ischemic strokes. According to studies, the risk of thrombus formation is nearly 15% in patients with non-valvular atrial fibrillation, and the LAA as the site for clot formation has more than 90% chance in these cases. Further, with the surgical approach of excluding the left atrial appendage from the circulation fraught with high rates of incomplete closure, leading to increased stroke risk, the demand for LAAC devices is rising.
Current evidence suggests that percutaneous occlusion of the left atrial appendage (LAA) is the most efficacious method in reducing the risk of thromboembolic complications associated with atrial fibrillation and is a rapidly growing discipline in the field of structural cardiac interventions. And also, the percutaneous left atrial appendage occlusion devices offer a viable alternative to oral anticoagulants in patients who have been deemed a high risk for bleeding or are otherwise ineligible to receive anticoagulation.
The Asia Pacific LAA (left atrial appendage) closure device market is being driven by an increase in the prevalence of atrial fibrillation in the geriatric population and technical advances. People over 65 are more likely to develop cardiovascular disorders, leading to heart stroke. As a result, healthy demand for these devices is projected over the forecast period. Furthermore, the market is being boosted by a spike in government activities to enhance public awareness about cardiovascular disorders.
In recent years, the surgical treatment of left atrial appendage occlusions has become more popular. Several surgical procedures for occluding the LAA using various devices have been devised, with varying success rates. For elderly persons with hypertension, kidney disease, or other comorbidities, surgical closure of the LAA sac is suggested. In addition, the surgical closure of the LAA has been linked to a lower risk of stroke and mortality in patients with atrial fibrillation, according to observational studies and clinical data. Over the forecast period, the market for left atrial appendage devices (LAA) is expected to grow at a 25% CAGR.
Endocardial and epicardial devices make up the market for LAA closure devices. The unit sales of endocardial devices will be the primary driver of growth in the LAA closure device market. This is owing to the fact that endocardial surgeries are the most popular, and endocardial devices have substantially higher ASPs than epicardial devices. While endocardial device growth is expected to be significant, epicardial clip device growth is also likely to be strong over the predicted period. In people with non-valvular atrial fibrillation, oral anticoagulation is the standard option for left atrial appendage closure devices, and it is widely recommended. In addition, the discovery of non-vitamin K oral anticoagulants (NOACs) such as rivaroxaban, dabigatran, apixaban, and edoxaban has made oral anticoagulants more accessible to individuals who are at risk of thromboembolic events.
The high cost of left atrial appendage atrial closure devices and the availability of alternatives may limit the market growth. Government restrictions governing LAA closure systems, on the other hand, are impeding this expansion.
The Amplatzer devices have been used in LAA occlusion for more than a decade, starting with the off-label use of an atrial septal occluder device for LAA occlusion. This was followed by introducing a dedicated Amplatzer cardiac plug (ACP) 1 and a second-generation Amulet device for LAA occlusion. Both these devices are widely used outside the United States; however, only the WATCHMAN device has been FDA approved in the US. However, some additional key questions remain unanswered before these devices gain widespread commercial use. These include training requirements, regulatory framework, the role of the learning curve, and most prominently, the selection of patient partners who are most likely to benefit from these devices.
According to the projections, roughly 75 million people in Asia will be diagnosed with atrial fibrillation and accompanying strokes by 2055. Furthermore, as the elderly become more sensitive to arrhythmia, ischemic stroke disease, and atrial fibrillation, the disease burden of atrial fibrillation will rise. In recent years, traditional surgical methods have resulted in partial closure, while more modern device-based procedures have become more popular. The penetration rate of LAA closure devices has increased due to these dynamics. The prevalence of AF(Atrial fibrillation ) has risen dramatically in recent years as AF diagnostic technology has improved and the older population has grown. Overall, as LAA closure devices gain popularity over anticoagulant treatment, the number of surgeries performed is increasing. More positive long-term results have been obtained before these techniques can be considered standard treatment. Therefore, the prevalence of atrial fibrillation among patients would rise during the anticipated period.
The LAA closure devices market is occupied by only a few market players, Boston Scientific, AtriCure, St. Jude Medical, Lifetech Scientific (Shenzhen), Coherex Medical, and Sentreheart, leaving the market with limited competition and a bundle of opportunities.
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