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Updated: Apr 25, 2026
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Left atrial appendage closure for stroke prevention in non-valvular atrial fibrillation: rationale, devices in
Martin W Bergmann1, Ulf Landmesser
1Department of Cardiology, Asklepios Clinic St. Georg, Hamburg, Germany.
Insights
Catheter-based left atrial appendage (LAA) occlusion offers a stroke prevention alternative for atrial fibrillation patients unsuitable for anticoagulation. European data show increasing use and improving safety of LAA occlusion devices.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Devices
Background:
- Atrial fibrillation (AF) poses a significant stroke risk, particularly in patients with contraindications to oral anticoagulation.
- Novel oral anticoagulants (NOACs) have limitations including bleeding risk and compliance issues.
- Catheter-based left atrial appendage (LAA) occlusion is an emerging non-pharmacological stroke prevention strategy.
Purpose of the Study:
- To summarize the rationale, clinical data, devices, implantation techniques, and follow-up for catheter-based LAA occlusion in Europe.
- To review the current status and future directions of LAA occlusion for stroke prevention in AF patients.
- To highlight the importance of operator training for procedural safety.
Main Methods:
- Review of European survey data on stroke prevention in AF.
- Analysis of clinical data and registry information for LAA occlusion devices (WATCHMAN, AMPLATZER Cardiac Plug, Coherex WaveCrest).
- Summary of implantation techniques and post-procedure drug regimens.
Main Results:
- European data indicate a need for non-pharmacological stroke prevention in AF.
- Long-term data for the WATCHMAN device suggest safety and efficacy.
- Registry data support the safety of AMPLATZER Cardiac Plug and Coherex WaveCrest devices.
Conclusions:
- Catheter-based LAA occlusion is a developing interventional approach for stroke prevention in AF.
- Improvements in implantation techniques and devices are expected to enhance procedural safety.
- Adequate operator training is crucial for successful LAA occlusion procedures.
Aims:
In patients with atrial fibrillation, a relevant stroke risk (CHA2DS2-VASc score ≥2) and a relative or absolute contraindication for oral anticoagulation, catheter-based LAA occlusion is performed increasingly in Europe. The present article summarises the rationale, clinical data, devices, implantation techniques and follow-up drug regimens.
Methods And Results:
European survey data on patients with atrial fibrillation support the need for non-pharmacological approaches for stroke prevention in patients with atrial fibrillation. A relevant bleeding risk remains with novel oral anticoagulants (NOACs), which are also dependent on drug compliance. Recent long-term data from the PROTECT-AF trial and the CAP registry regarding the WATCHMAN LAA occluder device suggest safety and efficacy. First registry data support the safety of two other CE-marked devices, the AMPLATZER Cardiac Plug (ACP) and the Coherex WaveCrest device, which have become available in Europe. Other LAA occlusion devices are in clinical development.
Conclusions:
Catheter-based LAA occlusion is now being developed further as an interventional approach for stroke prevention in patients with atrial fibrillation. Implantation techniques and devices are being improved, which will probably result in better procedural safety. Appropriate operator training is of major importance for this approach.
