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Related Concept Videos

Cardiac Catheterization III: Left Heart Catheterization01:24

Cardiac Catheterization III: Left Heart Catheterization

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Left heart catheterization is an invasive diagnostic procedure used to evaluate the function and structure of the left side of the heart. It is generally performed to diagnose and treat cardiovascular conditions such as valve abnormalities, coronary artery disease, and congenital heart defects.Diagnostic and therapeutic purposesLeft heart catheterization serves various diagnostic and therapeutic purposes, including:Assessing coronary artery bypass grafts.Evaluating coronary artery disease in...
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Related Experiment Video

Updated: Nov 14, 2025

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Percutaneous left atrial appendage occlusion in the current practice.

Ignacio Cruz-González1,2, Blanca Trejo-Velasco1

  • 1Cardiology Department, University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca (iBSAL), Salamanca, Spain

Kardiologia Polska
|March 10, 2021
PubMed
Summary

Left atrial appendage occlusion (LAAO) offers an alternative to oral anticoagulation (OAC) for stroke prevention in atrial fibrillation, particularly for high-bleeding-risk patients. Evidence from trials and registries supports LAAO devices, though optimal use and long-term outcomes require further study.

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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Medical Devices

Background:

  • Oral anticoagulation (OAC) is standard for stroke prevention in atrial fibrillation but carries bleeding risks.
  • The left atrial appendage is a primary source of stroke-causing thrombi in nonvalvular atrial fibrillation.
  • Percutaneous left atrial appendage occlusion (LAAO) is an emerging alternative for patients with high bleeding risk.

Purpose of the Study:

  • To review the current evidence supporting left atrial appendage occlusion (LAAO) devices for stroke prophylaxis.
  • To discuss the role of LAAO as an alternative to oral anticoagulation (OAC) in specific patient populations.
  • To highlight unresolved issues and future research directions in LAAO therapy.

Main Methods:

  • Review of evidence from randomized controlled trials (RCTs) comparing LAAO devices (Watchman, Amulet) with OAC.
  • Analysis of real-world registry data on LAAO outcomes in high-bleeding-risk patients.
  • Discussion of evidence on newer LAAO devices and their potential applications.

Main Results:

  • RCTs demonstrate LAAO efficacy in patients eligible for short-term OAC.
  • Registries show favorable outcomes with LAAO devices (Watchman, ACP, Amulet) in high-risk patients, often with reduced antithrombotic therapy.
  • Growing evidence exists for newer devices targeting specific patient subgroups.

Conclusions:

  • LAAO is an increasingly utilized alternative to OAC for stroke prevention in atrial fibrillation, especially in patients with high bleeding risk.
  • Optimal patient selection, device choice, and post-procedural antithrombotic strategies require further clarification.
  • Continued research is needed to assess the long-term comparative effectiveness of LAAO versus direct oral anticoagulants (DOACs).