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Updated: May 21, 2026
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
[Percutaneous left atrial appendage closure: an alternative in patients with atrial fibrillation and high bleeding
Stéphane Noble1, Hajo Müller, Tomoe Stampfli
1Unité de cardiologie interventionelle, HUG, Genève. stephane.noble@hcuge.ch
Insights
Atrial fibrillation (AF) increases stroke risk significantly. Left atrial appendage closure offers an alternative to oral anticoagulation for preventing strokes in high-risk AF patients.
Area of Science:
- Cardiology
- Neurology
- Medical Devices
Background:
- Atrial fibrillation (AF) is a prevalent cardiac arrhythmia, increasing stroke risk fivefold.
- AF-related strokes carry higher mortality and morbidity compared to those in sinus rhythm.
- Oral anticoagulation reduces stroke risk but carries a significant bleeding risk, leading to underutilization in 50% of indicated AF patients.
Purpose of the Study:
- To evaluate percutaneous left atrial appendage closure as an alternative stroke prevention strategy in AF patients.
- To address the limitations of oral anticoagulation in AF patients, including intolerance and bleeding risks.
Main Methods:
- Review of clinical data on percutaneous left atrial appendage closure procedures.
- Comparative analysis of stroke risk reduction and safety profiles between left atrial appendage closure and oral anticoagulation.
Main Results:
- Percutaneous left atrial appendage closure is established as a viable alternative for stroke prevention in AF.
- This method provides a solution for patients who cannot tolerate or have contraindications to oral anticoagulation.
Conclusions:
- Left atrial appendage closure is a crucial advancement in managing stroke risk for AF patients.
- It expands therapeutic options, improving patient outcomes and quality of life by mitigating bleeding risks associated with anticoagulation.
Abstract:
Atrial fibrillation (AF) is the most common cardiac arrhythmia and its prevalence increases with age. AF increases the risk of stroke by a factor of 5 and strokes related to AF are associated with higher mortality and morbidity when compared with strokes in patients with sinus rhythm. Oral anticoagulation is efficient to reduce the risk of stroke in AF patients, but with a substantial risk of bleeding. In clinical practice, 50% of the AF patients with an indication for oral anticoagulation do not receive the treatment. Indeed, many patients do not tolerate oral anticoagulation and this is still true despite the new drugs. Recently, percutaneous left atrial appendage closure for AF patients with high risk of stroke became a valid alternative to oral anticoagulation for stroke prevention.
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