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Updated: Apr 17, 2026
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
First Dutch experience with percutaneous left atrial appendage transcatheter occlusion
Insights
Percutaneous left atrial appendage (LAA) occlusion offers a potential alternative to oral anticoagulation for patients with atrial fibrillation (AF). This minimally invasive procedure showed feasibility and was well-tolerated in a small patient group.
Area of Science:
- Cardiology
- Medical Devices
- Interventional Cardiology
Background:
- Patients with atrial fibrillation (AF) face a heightened risk of thromboembolic stroke.
- Oral anticoagulation is effective but can be difficult to manage or contraindicated.
- Left atrial appendage (LAA) thrombi are common in nonrheumatic AF, making LAA occlusion a target for stroke prevention.
Purpose of the Study:
- To evaluate the feasibility of percutaneous transcatheter LAA occlusion as an alternative to oral anticoagulation.
- To assess the safety and tolerability of a novel LAA occlusion device.
Main Methods:
- Three patients underwent percutaneous transcatheter LAA occlusion implantation.
- Procedures were guided by intracardiac and transoesophageal echocardiography.
- No general anesthesia was used, and patients were monitored for long-term follow-up.
Main Results:
- LAA occlusion device implantation was successfully performed without major complications.
- The procedure was well-tolerated by all three patients.
- Patients were enrolled in a long-term follow-up study.
Conclusions:
- Transseptal percutaneous LAA occlusion is a feasible procedure.
- The role of LAA occlusion as an alternative to oral anticoagulation requires further investigation.
Background:
Patients with atrial fibrillation (AF) have an increased risk of thromboembolic stroke, dependent on clinical variables. Oral anticoagulation significantly decreases the risk of stroke or embolism, but sometimes this is difficult to manage and may be contraindicated. Approximately 90% of atrial thrombi in nonrheumatic AF are found in the left atrial appendage (LAA). A new device has been developed which allows percutaneous LAA occlusion (PLAATO) and might be an alternative to oral anticoagulation. Feasibility in dogs and humans was described previously.
Methods And Results:
As part of an international multicentre trial, three patients received a percutaneous transcatheter LAA occlusion device. Implantations were performed without general anaesthesia, guided by intracardiac and transoesophageal echocardiography and without major complications. The implantations were well tolerated by the patients, who entered a long-term follow-up to be compared with a historical control group.
Conclusion:
Transseptal percutaneous LAA occlusion is feasible. Its role as an alternative to oral anticoagulation, however, needs to be further defined.
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