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Updated: Jul 21, 2026
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
Left Atrial Appendage Occlusion: British Cardiovascular Intervention Society and British Heart Rhythm Society
Tim R Betts1, Patrick A Calvert2, Lee N Graham3
1Cardiac Electrophysiology, Oxford University Hospitals NHS Foundation Trust Oxford, UK.
Insights
Percutaneous left atrial appendage occlusion offers a stroke risk reduction strategy for atrial fibrillation patients unsuitable for anticoagulation. This statement outlines evidence, indications, and best practices for the procedure.
Area of Science:
- Cardiology
- Medical Devices
- Interventional Procedures
Background:
- Atrial fibrillation (AF) increases stroke risk, especially in patients ineligible for anticoagulation.
- Percutaneous left atrial appendage occlusion (LAAO) is an alternative stroke prevention method.
- LAAO has demonstrated efficacy in clinical trials and received regulatory approval.
Purpose of the Study:
- To summarize current evidence supporting LAAO for stroke risk reduction in AF.
- To define current indications for LAAO procedures.
- To provide consensus on best practices for LAAO.
Main Methods:
- Review of international randomized trials and registries.
- Analysis of National Institute for Health and Care Excellence (NICE) and NHS England guidelines.
- Consensus development on procedural planning, implantation, and follow-up.
Main Results:
- LAAO is an established procedure for stroke prevention in select AF patients.
- Evidence supports its use, leading to regulatory approvals and guideline inclusion.
- Best practices encompass pre-procedure planning, safe implantation, and post-procedure care.
Conclusions:
- LAAO is a viable option for reducing stroke risk in AF patients who cannot tolerate anticoagulation.
- Standardized approaches to planning, execution, and follow-up are crucial for optimal outcomes.
- Establishing procedural volume standards and multidisciplinary team involvement enhances safety and efficacy.
Abstract:
Percutaneous left atrial appendage occlusion aims to reduce the risk of stroke in patients with AF, particularly those who are not good candidates for systemic anticoagulation. The procedure has been studied in large international randomised trials and registries and was approved by the National Institute for Health and Care Excellence in 2014 and by NHS England in 2018. This position statement summarises the evidence for left atrial appendage occlusion and presents the current indications. The options and consensus on best practice for pre-procedure planning, undertaking a safe and effective implant and appropriate post-procedure management and follow-up are described. Standards regarding procedure volume for implant centres and physicians, the role of multidisciplinary teams and audits are highlighted.
