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Updated: Jan 16, 2026

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
28:13

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Published on: February 26, 2013

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2025 SCAI/HRS Clinical Practice Guidelines on Transcatheter Left Atrial Appendage Occlusion

Andrew M Goldsweig1, Michael Glikson2, Jacqueline Joza3

  • 1Department of Cardiovascular Medicine, Baystate Medical Center and Division of Cardiovascular Medicine, University of Massachusetts-Baystate, Springfield, Massachusetts.

Journal of the Society for Cardiovascular Angiography & Interventions
|October 3, 2025
PubMed

Insights

Left atrial appendage occlusion (LAAO) devices help prevent stroke in atrial fibrillation patients. These guidelines offer evidence-based recommendations for LAAO patient selection, imaging, and managing complications like peridevice leak.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Electrophysiology

Background:

  • Left atrial appendage occlusion (LAAO) devices are effective in reducing stroke risk for atrial fibrillation patients compared to no anticoagulation.
  • Practice variations and uncertainties exist regarding optimal patient selection, imaging, antithrombotic therapy, and management of peridevice leak (PDL) and device-related thrombus (DRT).

Purpose of the Study:

  • To provide evidence-based guidelines for clinicians, patients, and stakeholders on LAAO management.
  • To address variations in care and support decision-making for LAAO procedures.

Main Methods:

  • A multidisciplinary guideline panel was convened by the Society for Cardiovascular Angiography & Interventions and Heart Rhythm Society.
  • Recommendations were developed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach, informed by systematic reviews and an evidence-to-decision framework.

Main Results:

  • Eight evidence-based recommendations were developed to address variations in LAAO care.
  • Two key knowledge gaps were identified, highlighting areas for future research.

Conclusions:

  • Key recommendations focus on patient selection, periprocedural imaging, antithrombotic therapy, and management of PDL and DRT.
  • Future research is recommended on single antiplatelet therapy post-LAAO and PDL management.
Abstract

Keywords:
anticoagulationantiplatelet therapyatrial fibrillationleft atrial appendage occlusionprocedural imagingstroke

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