Application Detail

Description of Medical Service

The medical service is the percutaneous insertion of a left atrial appendage closure (LAAC) device to occlude the left atrial appendage (LAA) in patients with non-valvular atrial fibrillation (NVAF). The LAA is the primary source for thromboembolism in patients with NVAF. The procedure aims at preventing stroke and systemic thromboembolism by closing off the LAA permanently to avoid the formation and migration of emboli to the brain.The implantation procedure uses standard transseptal techniques. The access sheath and delivery catheter permit device placement in the LAA via femoral venous access and inter-atrial septum crossing into the left atrium. The device is unsheathed when in the appropriate position.The procedure is performed under local or general anaesthesia by an interventional cardiologist or cardiac electrophysiologist in a catheterisation laboratory under guidance of fluoroscopy and transoesophageal echocardiogram (TOE). The procedure takes approximately 60 minutes.

Description of Medical Condition

Atrial Fibrillation (AF) is the most common sustained cardiac arrhythmia and a key risk factor for ischaemic strokes. A thrombus can form when blood becomes trapped in the LAA due to fibrillation. When the thrombus becomes dislodged it migrates through the arterial system towards the brain, resulting in vascular occlusion from the thromboembolism which may cause an ischemic stroke. Ischemic strokes can lead to a large number of complications including hemi-paralysis, speech deficits, dysphasia, and even death.

Reason for Application

Amendment to an existing MBS item

Medical Service Type

Therapeutic

Previous Application Number/s

Not Applicable

Associated Documentation

Application Form

Application Form (PDF 2028 KB)
Application Form (Word 1767 KB)

Consultation Survey

Consultation Survey (PDF 559 KB)
Consultation Survey (Word 70 KB)

PICO Confirmation

PICO Confirmation (PDF 1697 KB)
PICO Confirmation (Word 1600 KB)

Assessment Report

-

Public Summary Document

Public Summary Document (PDF 722 KB)
Public Summary Document (Word 199 KB)

Meetings for this Application

PASC

17 April 2020

ESC

11-12 February 2021

MSAC

31 March - 1 April 2021