Related Experiment Video
Updated: Jun 20, 2026
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Percutaneous left atrial appendage transcatheter occlusion (PLAATO) for stroke prevention in atrial fibrillation:
Jai-Wun Park1, Boris Leithäuser, Ulrich Gerk
1Hoyerswerda Hospital, 1st Medical Department, Cardiology, Angiology, Nephrology, Academic Teaching Hospital of the Technical University of Dresden, Hoyerswerda, Germany. jai-wunpark@t-online.de
Insights
Percutaneous left atrial appendage transcatheter occlusion (PLAATO) effectively prevents strokes in atrial fibrillation (AF) patients. This minimally invasive procedure offers a safe alternative to anticoagulation therapy for stroke risk reduction.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Devices
Background:
- Atrial fibrillation (AF) significantly increases stroke risk due to emboli from the left atrial appendage (LAA).
- Anticoagulation therapy is standard but contraindicated or rejected in some AF patients.
- Transcatheter LAA occlusion presents a potential alternative to reduce stroke risk.
Purpose of the Study:
- To evaluate the stroke risk reduction in AF patients two years after percutaneous left atrial appendage transcatheter occlusion (PLAATO).
Main Methods:
- A single-center prospective registry study.
- Seventy-three AF patients (contraindicated/rejected anticoagulation) underwent PLAATO.
- Follow-up was conducted for 24 months, with device stability assessed by transesophageal echocardiography (TEE).
Main Results:
- Two patients experienced periprocedural complications (implant embolization, instability requiring surgery).
- Of the 71 followed patients, 52 showed stable PLAATO device anchoring without migration.
- No strokes were reported during the 24-month follow-up, compared to an expected 7 strokes.
- Ten patients died during follow-up, none from stroke.
Conclusions:
- PLAATO achieved successful treatment in 97% of AF patients.
- Mechanical LAA occlusion with PLAATO markedly reduces the 2-year stroke risk in AF patients.
- PLAATO is a viable therapeutic option for AF patients with contraindications to oral anticoagulation.
Purpose:
In more than 90% of patients with atrial fibrillation (AF), stroke is due to thrombotic embolization from the left atrial appendage (LAA). Transcatheter occlusion with percutaneous left atrial appendage transcatheter occlusion (PLAATO), a self-expanding, membrane- covered spherical nitinol cage, is feasible and an alternative to anticoagulation therapy.
Methods:
This was a single-center prospective registry study for verification of stroke risk reduction in patients with AF 2 years after PLAATO.
Results:
Seventy-three patients with AF (permanent 65, paroxysmal 8) in whom anticoagulation therapy was contraindicated or rejected underwent transcatheter LAA occlusion with PLAATO. One patient died periprocedurally due to implant embolization, and 1 patient underwent open-heart surgery because of implant instability. The remaining 71 patients were followed for 24 months. In 52 patients a stable anchoring of the PLAATO device without migration or dislocation was documented by transesophageal echocardiography (TEE). No thrombotic deposition was found on the LA luminal surface of the device. Statistically, in our patient cohort, 7 strokes would have been expected without any treatment within 24 months. In fact, no strokes were reported. Ten out of 71 patients died during follow up: 6 in our hospital and 4 at home. None of them died from a stroke.
Conclusions:
Ninety-seven percent of AF patients were successfully treated with PLAATO. After mechanical LAA occlusion, the 2-year risk of stroke in AF patients is markedly reduced. Therefore, this therapeutic concept is a clear alternative for patients with AF and contraindications for oral anticoagulation.
