Percutaneous left atrial appendage occlusion for thromboembolism protection in patients with atrial fibrillation

peer reviewedAtrial fibrillation (AF) is the most common clinical arrythmia and can be associated with severe thromboembolic complications. For different reasons, a large number of AF patients who would benefit from oral anticoagulation (OAC) are not treated. In case of contra-indications to long-term OAC, left atrial appendage (LAA) closure allows the exclusion of the LAA from the systemic circulation and significantly reduces the thromboembolism risk. Results from large randomized trials show that this technique is non-inferior in terms of efficacy compared to OAC and that it can significantly reduce the rate of haemorrhagic complications. Large-scale registries show promising results in patients with contra-indications to long-term OAC. Clinical trials are under way to define the role and spectrum of LAA occlusion and to optimize post-procedural treatment