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Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
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Related Experiment Video

Updated: Jan 7, 2026

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Left atrial appendage closure: Current status, unresolved issues, and future perspectives.

Yusuke Kondo1, Satoko Ryuzaki2, Miyo Nakano3

  • 1Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, 260-8670, 1-8-1 Inohana, Chuo-ku, Japan. simokita9933@msn.com.

Cardiovascular Intervention and Therapeutics
|December 11, 2025
PubMed
Summary

Left atrial appendage closure (LAAC) offers stroke prevention for nonvalvular atrial fibrillation (AF) patients unable to use oral anticoagulation (OAC). Ongoing research focuses on optimizing device safety, reducing complications like device-related thrombus, and expanding LAAC indications.

Keywords:
Atrial fibrillation (AF)Left atrial appendage closure (LAAC)Non-valvular atrial fibrillation (NVAF)Stroke

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Area of Science:

  • Cardiology
  • Medical Devices
  • Stroke Prevention

Background:

  • Left atrial appendage closure (LAAC) is a key stroke prevention therapy for nonvalvular atrial fibrillation (AF) patients contraindicated for oral anticoagulation (OAC).
  • LAAC adoption is increasing in Japan, exceeding 10,000 procedures.
  • Current indications are restricted to high-risk patients.

Purpose of the Study:

  • To review the current status, challenges, and future directions of LAAC, focusing on the WATCHMAN device.
  • To discuss advancements in LAAC devices and imaging techniques.
  • To explore future priorities for expanding LAAC use and improving patient outcomes.

Main Methods:

  • Review of clinical trials and registries evaluating LAAC devices (WATCHMAN FLX, FLX Pro, Amulet).
  • Analysis of safety and efficacy data compared to oral anticoagulation.
  • Evaluation of emerging technologies like intracardiac echocardiography (ICE) and pulsed field ablation (PFA).

Main Results:

  • LAAC demonstrates stroke prevention efficacy comparable to OAC with a lower risk of bleeding.
  • WATCHMAN FLX/FLX Pro show improved safety and adaptability.
  • Device-related thrombus (DRT) and peri-device leak (PDL) remain significant concerns requiring optimized antithrombotic therapy.
  • Amulet offers superior sealing but has higher complication rates.
  • ICE enables less invasive procedures and same-session AF ablation.

Conclusions:

  • LAAC is an effective stroke prevention strategy for selected AF patients.
  • Addressing DRT and PDL is crucial for long-term success.
  • Technological advancements like ICE and PFA are enhancing procedural efficiency and enabling integrated approaches.
  • Future research should focus on risk stratification, personalized antithrombotic regimens, and broadening LAAC indications.