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Updated: Jun 5, 2026
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
An International Consensus Practical Guide on Left Atrial Appendage Closure for the Non-implanting Physician:
Tatjana Potpara1, Marek Grygier2, Karl Georg Haeusler3
1Medical Faculty, University of Belgrade, University Clinical Centre of Serbia, Belgrade, Serbia.
Insights
Many atrial fibrillation patients avoid oral anticoagulation due to bleeding risks. Left atrial appendage closure (LAAC) offers a safer alternative for stroke prevention in these individuals.
Area of Science:
- Cardiology
- Medical Devices
- Interventional Cardiology
Background:
- Oral anticoagulation is crucial for stroke prevention in atrial fibrillation (AF) but is often underused or discontinued.
- Reasons for underuse include bleeding risks, poor compliance, and patient aversion to anticoagulant therapy.
- Direct oral anticoagulants (DOACs) have improved but not eliminated these issues.
Purpose of the Study:
- To provide an executive summary of a practical guide on left atrial appendage closure (LAAC).
- To introduce LAAC devices and implantation techniques for non-implanting physicians.
- To guide physicians in referring appropriate AF patients for LAAC consideration.
Main Methods:
- The article summarizes an international expert consensus practical guide.
- It covers LAAC device types and implantation procedures.
- Indications for LAAC and device follow-up protocols are detailed.
Main Results:
- Left atrial appendage closure (LAAC) is an increasingly favored catheter-based approach for thromboembolic event prevention.
- Procedural safety improvements have made LAAC a viable option for AF patients unsuitable for long-term oral anticoagulation.
- The practical guide offers comprehensive information aligned with current guidelines.
Conclusions:
- LAAC is a valuable alternative for stroke prevention in AF patients who cannot tolerate oral anticoagulation.
- This summary serves as a reference for physicians needing to refer patients for LAAC.
- Understanding LAAC indications and follow-up is essential for appropriate patient selection and management.
Abstract:
Many patients with atrial fibrillation (AF) who are in need of stroke prevention are not treated with oral anticoagulation or discontinue treatment shortly after its initiation. Despite the availability of direct oral anticoagulants (DOACs), such undertreatment has improved somewhat but is still evident. This is due to continued risks of bleeding events or ischemic strokes while on DOAC, poor treatment compliance, or aversion to anticoagulant therapy. Because of significant improvements in procedural safety over the years left atrial appendage closure (LAAC), using a catheter-based, device implantation approach, is increasingly favored for the prevention of thromboembolic events in AF patients who cannot have long-term oral anticoagulation. This article is an executive summary of a practical guide recently published by an international expert consensus group, which introduces the LAAC devices and briefly explains the implantation technique. The indications and device follow-up are more comprehensively described. This practical guide, aligned with published guideline/guidance, is aimed at those non-implanting physicians who may need to refer patients for consideration of LAAC.
