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Standardized endpoint definitions for trials of transcatheter left atrial appendage closure: a consensus from the Left Atrial Appendage Academic Research Consortium†.

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Updated: Apr 20, 2026

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Antithrombotic therapy after left atrial appendage closure.

Boris Schmidt1, Kyoung Ryul Julian Chun

  • 1Cardioangiologisches Centrum Bethanien, AGAPLESION Markus Krankenhaus, Wilhelm-Epstein Str. 4, 60431 Frankfurt/Main, Germany.

Expert Review of Cardiovascular Therapy
|December 2, 2014
PubMed
Summary

Preventing device-related clots after left atrial appendage closure is crucial. Optimal antithrombotic therapy, especially in high-bleeding-risk patients, requires further investigation to balance efficacy and safety.

Keywords:
antithrombotic therapyatrial fibrillationleft atrial appendageocclusionstroke

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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Thrombosis Research

Background:

  • Left atrial appendage closure is an alternative to anticoagulation for stroke prevention.
  • Preventing thrombus formation on the device is critical post-procedure.
  • Most patients undergoing closure have contraindications to oral anticoagulation due to bleeding history.

Purpose of the Study:

  • To review antithrombotic strategies for left atrial appendage closure.
  • To address the challenges in selecting optimal antithrombotic therapy in real-world patients.
  • To highlight the need for further research on antithrombotic duration and novel agents.

Main Methods:

  • Review of clinical studies and real-world data on antithrombotic therapy post-left atrial appendage closure.
  • Analysis of dual antiplatelet therapy strategies in patients with contraindications to oral anticoagulation.
  • Discussion of current knowledge gaps and future research directions.

Main Results:

  • Dual antiplatelet therapy is a viable option for patients ineligible for oral anticoagulation.
  • The optimal duration of antithrombotic therapy remains undetermined.
  • Further investigation is needed for direct oral anticoagulants and long-term aspirin use.

Conclusions:

  • Antithrombotic therapy selection after left atrial appendage closure is complex, particularly in high-risk patients.
  • Evidence supports dual antiplatelet therapy as an alternative, but optimal duration is unknown.
  • Future research should focus on direct oral anticoagulants and the necessity of long-term aspirin therapy.