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Updated: Oct 11, 2025
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Left atrial appendage closure - Current status and future directions
Mesfer Alfadhel1, Thomas Nestelberger2, Rohit Samuel1
1Division of Cardiology, Vancouver General Hospital, University of British Columbia, Canada.
Insights
Percutaneous left atrial appendage closure (LAAC) offers stroke prevention for atrial fibrillation (AF) patients at high bleeding risk. This review covers current and future studies on leading LAAC devices like Watchman and Amplatzer.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Medical Device Technology
Background:
- Atrial fibrillation (AF) increases stroke risk, necessitating effective prevention strategies.
- Percutaneous left atrial appendage closure (LAAC) provides a non-pharmacological option for stroke risk reduction.
- LAAC is particularly crucial for patients with high bleeding risk who cannot tolerate anticoagulation.
Purpose of the Study:
- To review recent, current, and future studies on percutaneous left atrial appendage closure (LAAC).
- To analyze the safety and long-term efficacy of leading LAAC devices and their next-generation iterations.
- To explore the expanding role of LAAC in stroke prevention for non-valvular atrial fibrillation (AF) patients.
Main Methods:
- Comprehensive literature review of studies focusing on LAAC procedures.
- Analysis of data pertaining to the Watchman device and the Amplatzer cardiac plug (ACP).
- Examination of clinical evidence for next-generation devices: Watchman FLX and Amulet.
Main Results:
- Growing evidence supports the safety and long-term efficacy of LAAC in specific patient populations.
- Increased adoption of LAAC devices for stroke prevention in non-valvular AF.
- Ongoing research focuses on technological advancements and expanding the eligible patient pool for LAAC.
Conclusions:
- Percutaneous left atrial appendage closure is an established and evolving intervention for stroke prevention in AF.
- Continued research and device development are expanding the utility and accessibility of LAAC.
- LAAC offers a vital alternative for patients at high risk of bleeding on anticoagulation therapy.
Abstract:
Percutaneous left atrial appendage closure (LAAC) has become an important non-pharmacological intervention for stroke prevention in patients with non-valvular atrial fibrillation (AF). LAAC aims to reduce the risk of thromboembolism without increasing the risk of bleeding, a crucial strategy for patients at high risk for bleeding. Over the last few decades, the safety and long-term efficacy of the procedure in specific populations have grown, and more patients are being treated with these devices. Current and future studies focus on expanding the target population as well as the iteration of current technology. This article reviews recent, present, and future LAAC studies on the two most common devices, the Watchman device (Boston Scientific Corporation) and the Amplatzer cardiac plug (ACP) (St. Jude Medical, Minneapolis, MN), and their subsequent next generations, the Watchman FLX, and the Amulet, respectively.
