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Updated: Aug 13, 2026
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Intracardiac devices for stroke prevention
Thuraia Nageh1, Bernhard Meier
1Swiss Cardiovascular Center, Bern, Switzerland.
Insights
Atrial fibrillation and patent foramen ovale increase stroke risk. Intracardiac devices offer alternatives for stroke prevention when anticoagulation is unsuitable.
Area of Science:
- Cardiology
- Neurology
- Medical Devices
Background:
- Stroke is a leading cause of death and disability globally.
- Cardiac embolism, often from atrial fibrillation or patent foramen ovale, is a major stroke cause.
- Oral anticoagulation is effective but has limitations, necessitating alternative stroke prevention strategies.
Purpose of the Study:
- To review intracardiac devices and techniques for stroke prevention.
- To discuss the role of left atrial appendage occlusion and patent foramen ovale closure.
- To compare the merits of different interventional approaches for stroke risk reduction.
Main Methods:
- Discussion of percutaneous left atrial appendage occlusive devices.
- Review of surgical appendage obliteration techniques.
- Analysis of percutaneous patent foramen ovale closure procedures.
Main Results:
- Left atrial appendage occlusion and patent foramen ovale closure are emerging as viable options for stroke prevention.
- Percutaneous closure of patent foramen ovale is safe and effective for preventing recurrent strokes.
- These devices offer alternatives for patients unable to tolerate long-term oral anticoagulation.
Conclusions:
- Intracardiac devices provide important therapeutic options for stroke prevention.
- Left atrial appendage occlusion and patent foramen ovale closure are key interventional strategies.
- The choice of device and technique depends on individual patient factors and clinical context.
Abstract:
Stroke is a significant cause of serious disability and death worldwide. A substantial proportion of strokes are related to an underlying cardiac embolic source, most commonly in association with atrial arrhythmias (fibrillation/flutter). Atrial fibrillation is considered a major risk factor for stroke. Although long-term prophylactic oral anticoagulation has been shown to be very effective in reducing stroke in patients with atrial fibrillation, it has a number of major limitations and is not feasible in all patients. In such cases, the use of percutaneously (transvenous) implanted left atrial appendage occlusive devices or surgical appendage obliteration is being explored. Similarly, the presence of a patent foramen ovale, especially in the presence of an atrial septal aneurysm, is now recognized as an important potential mediator of paradoxical cardiogenic embolism. Percutaneous patent foramen ovale closure is becoming increasingly established as a safe and effective means of preventing recurrent strokes in the presence of a patent foramen ovale. In this account, the authors discuss the intracardiac devices and techniques available and the relative merits of their use for stroke prevention.
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