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Updated: Jun 18, 2026
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Left atrial appendage-occluding devices for stroke prevention in patients with nonvalvular atrial fibrillation
Bryan P Yan1, Thomas J Kiernan, Ignacio Gonzales-Cruz
1Department of Medicine & Therapeutics, Chinese University of Hong Kong, Hong Kong, China. bryan.yan@cuhk.edu.hk
Insights
Atrial fibrillation increases stroke risk, often from clots in the left atrial appendage (LAA). LAA occlusion offers a promising alternative to blood thinners for stroke prevention in select patients.
Area of Science:
- Cardiology
- Medical Devices
Background:
- Atrial fibrillation (AF) significantly elevates stroke risk due to thromboembolic events.
- Vitamin K antagonists are standard anticoagulation but have limitations in efficacy and monitoring.
- The left atrial appendage (LAA) is the primary source of thromboembolism in nonvalvular AF.
Purpose of the Study:
- To evaluate percutaneous transcatheter techniques for left atrial appendage (LAA) exclusion.
- To assess the potential of LAA occlusion as an alternative to anticoagulation therapy.
Main Methods:
- Review of percutaneous transcatheter LAA exclusion devices, including WATCHMAN and AMPLATZER.
- Analysis of procedural outcomes and efficacy in preventing thromboembolic events.
Main Results:
- Percutaneous LAA exclusion techniques have demonstrated encouraging results.
- Occlusion of the LAA effectively prevents thrombus formation within the appendage.
Conclusions:
- Left atrial appendage occlusion is a viable alternative to vitamin K antagonist therapy for selected AF patients.
- Transcatheter LAA exclusion offers a promising strategy for stroke risk reduction in atrial fibrillation.
Abstract:
Atrial fibrillation is associated with a fivefold increased risk for stroke, mostly secondary to thromboembolic events. Anticoagulation with a vitamin K antagonist is the standard medical therapy for these patients but is difficult to maintain within the therapeutic range and requires frequent monitoring and dose adjustments. Approximately 90% of thromboembolism occurs in the left atrial appendage (LAA) in patients with nonvalvular atrial fibrillation. Occlusion of flow into the LAA may prevent thrombus formation in the appendage and, hence, reduction of stroke. Recently, several percutaneous transcatheter techniques of LAA exclusion using the Percutaneous Left Atrial Appendage Transcatheter Occlusion device, the WATCHMAN device, and AMPLATZER septal occluder and cardiac plug have been employed, with encouraging results. Occlusion of the LAA may be an alternative to vitamin K antagonist therapy for selected patients.
