Left Atrial Appendage Closure for Stroke Prevention in Atrial Fibrillation: Current Status and Perspectives

Atrial fibrillation (AF) increases the risk of stroke and systemic embolism. While oral anticoagulation is the current standard of care, there is a growing body of evidence supporting left atrial appendage closure (LAAC) as an alternative or complementary treatment approach to reduce the risk of stroke or systemic embolism in patients with AF. An increasing number of randomized clinical trials studying the efficacy and safety of catheter-based LAAC in comparison with medical noninterventional treatment are giving further insights into this topic. Furthermore, robust randomized data about surgical LAAC in patients with AF undergoing cardiac surgery showed a significant reduction of the risk of stroke on the background of continued anticoagulation therapy. In this review, the authors describe the rapidly evolving field of LAAC and discuss recent clinical data, ongoing studies, open questions, and current limitations of LAAC.