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Updated: Jan 16, 2026
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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
33.9K
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.
Summary
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.
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