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Updated: May 20, 2026
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Evidence-based percutaneous closure of the left atrial appendage in patients with atrial fibrillation
Silvio Leal1, Raul Moreno, Manuel de Sousa Almeida
1Cardiovascular Intervention Unit, Cardiology Service, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal. silvionleal@gmail.com
Insights
Left atrial appendage closure offers a new stroke prevention method for atrial fibrillation patients unable to use blood thinners. This minimally invasive procedure shows promise but carries potential risks.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Devices
Background:
- Atrial fibrillation is a common arrhythmia with increasing prevalence.
- Cardioembolic stroke, often from left atrial appendage thrombus, is a major complication.
- Vitamin-K antagonists are standard stroke prophylaxis but have limitations.
Purpose of the Study:
- To review the current state of percutaneous left atrial appendage closure.
- To evaluate this novel strategy for stroke prophylaxis in atrial fibrillation.
- To discuss devices and outcomes for left atrial appendage closure.
Main Methods:
- Review of current literature on percutaneous left atrial appendage closure devices.
- Analysis of feasibility, efficacy, and complication rates.
- Synthesis of data on stroke prevention in atrial fibrillation.
Main Results:
- Percutaneous left atrial appendage closure is a feasible alternative for stroke prevention.
- Devices demonstrate good efficacy with high successful implantation rates.
- Potential periprocedural complications are associated with the procedure.
Conclusions:
- Percutaneous left atrial appendage closure is a promising alternative for high-risk atrial fibrillation patients.
- It provides stroke prophylaxis for those with contraindications to oral anticoagulation.
- Further evaluation of device safety and long-term efficacy is ongoing.
Abstract:
Atrial fibrillation is the most common cardiac arrhythmia, and its prevalence is increasing. Cardioembolic stroke, most of the times secondary to thrombus formation in the left atrial appendage, is its most feared and life threatening consequence. Oral anticoagulation with vitamin-K-antagonists is currently the most used prophylaxis for stroke in patients with atrial fibrillation; unfortunately, its benefits are limited by a narrow therapeutic window and an increased risk for bleeding, making it often undesired. Percutaneous occlusion of the left atrial appendage is a novel alternative strategy for cardioembolic stroke prophylaxis in patients with atrial fibrillation at a high risk of stroke but with contraindication for long-term oral anticoagulation therapy. At present, several devices have been developed specifically for percutaneous occlusion of the left atrial appendage. Current results show good feasibility and efficacy for these devices, with a high rate of successful implantation, although also associated with the inherent potential periprocedural complications. This work reviews the current state of the art of percutaneous left atrial appendage closure for stroke prophylaxis in patients with atrial fibrillation.
