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Updated: Apr 26, 2026
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Mechanical closure devices for atrial fibrillation
Matthew J Price1, David R Holmes2
1Scripps Clinic, La Jolla, CA.
Insights
Left atrial appendage (LAA) closure offers a mechanical stroke prevention strategy for atrial fibrillation (AF) patients. This approach addresses limitations of anticoagulation, particularly for those with contraindications.
Area of Science:
- Cardiology
- Medical Devices
- Stroke Prevention
Background:
- Atrial fibrillation (AF) is a common arrhythmia linked to stroke and embolism.
- Oral anticoagulation reduces stroke risk but increases bleeding complications.
- Many AF patients at high stroke risk are undertreated due to contraindications.
Purpose of the Study:
- To review the rationale for left atrial appendage (LAA) device closure.
- To summarize existing data on LAA closure devices.
- To propose a framework for selecting patients for LAA device therapy.
Main Methods:
- Literature review of studies on LAA closure devices.
- Analysis of current clinical datasets for LAA closure.
- Development of a patient selection framework.
Main Results:
- The left atrial appendage (LAA) is a primary source of thromboembolism in AF.
- LAA device closure presents a mechanical alternative to anticoagulation.
- Existing data supports the efficacy and safety of LAA closure devices.
Conclusions:
- LAA device closure is a viable stroke prevention strategy for select AF patients.
- This mechanical approach can overcome anticoagulation limitations.
- A structured patient selection process is crucial for optimal outcomes.
Abstract:
Atrial fibrillation (AF) is the most commonly sustained arrhythmia and is a major cause of stroke and systemic embolism. Chronic oral anticoagulation reduces this risk, but at the cost of increased bleeding. In addition, a substantial proportion of AF patients who are at moderate-to-high risk for stroke are undertreated due to real or perceived contraindications. The major source of thromboembolism in AF appears to be the left atrial appendage (LAA). Therefore, device closure of the LAA represents a mechanical approach to stroke prevention in AF patients. In this review, we describe the rationale for device closure of the LAA, summarize the current dataset for LAA closure devices, and set forth a framework to help guide patient selection for device therapy.
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