Related Experiment Video

Updated: Aug 22, 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

Concomitant Left Atrial Appendage Occlusion and Transcatheter Aortic Valve Replacement: A Systematic Review and

Krishna S Gajula1, Shanmukh Sai Pavan Lingamsetty2, Hrushikesh R Pamreddy3

  • 1Department of Cardiovascular Medicine, Saint Vincent Hospital, UMass Chan Medical School, Worcester, Massachusetts.

Journal of the Society for Cardiovascular Angiography & Interventions
|August 21, 2026
PubMed

Insights

Combining left atrial appendage occlusion (LAAO) with transcatheter aortic valve replacement (TAVR) in atrial fibrillation patients showed no significant short-term differences in mortality or bleeding. Further research is needed to confirm these findings.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Medical Devices

Background:

  • Atrial fibrillation (AF) is common in patients undergoing transcatheter aortic valve replacement (TAVR).
  • AF increases risks of stroke and bleeding, necessitating anticoagulation.
  • Left atrial appendage occlusion (LAAO) is a potential strategy to mitigate these risks during TAVR.

Purpose of the Study:

  • To evaluate the safety and efficacy of concomitant LAAO during TAVR in patients with AF.
  • To compare outcomes of TAVR + LAAO versus TAVR + standard medical therapy.

Main Methods:

  • A systematic literature search of PubMed, Embase, and Cochrane databases was conducted up to May 2025.
  • Four studies (2 RCTs, 2 observational studies; n=563) were included in the meta-analysis.
  • Random-effects models were used to pool risk ratios (RRs) and 95% confidence intervals (CIs).

Main Results:

  • No significant differences were observed at 30 days for mortality (RR 0.91), stroke/TIA (RR 0.27), or major bleeding (RR 0.27).
  • Long-term follow-up (9.8 months to 2 years) also showed similar rates of all-cause mortality (RR 0.95), cardiac death (RR 0.95), stroke/TIA (RR 1.33), and major bleeding (RR 1.06).
  • Contrast use and hospital length of stay were comparable between groups.

Conclusions:

  • Concomitant TAVR and LAAO is feasible and appears safe in the short term, with no significant increase in adverse events compared to TAVR alone.
  • The current evidence is limited, with low certainty, and findings are hypothesis-generating.
  • Larger randomized trials and prospective registries are warranted to definitively establish the benefits of combined TAVR and LAAO.
Abstract

Keywords:
atrial fibrillationconcomitant procedureleft atrial appendage occlusionmajor bleedingstroke preventiontranscatheter aortic valve interventiontranscatheter aortic valve replacement

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