Percutaneous left atrial appendage occlusion (LAAO) is a device-based therapy for the prevention of stroke in patients with non-valvular atrial fibrillation (AF). Recently, the Watchman device (Boston Scientific, St Paul, MN, US) was approved in the US by the Food and Drug Administration (FDA) based on the results of two randomised clinical trials that evaluated LAAO in patients eligible for oral anticoagulation (OAC) therapy. However, in real-word clinical practice LAAO is typically offered to patients ineligible for OAC therapy, as they appear to have limited treatment options and consequently worse prognosis. Although LAAO has shown favourable clinical outcomes in OAC-ineligible patients in single or multicentre observational studies, these results need to be confirmed in randomised clinical trials.
Apostolos Tzikas - AHEPA University Hospital, Thessaloniki, Greece
Darren Mylotte - Department of Interventional Cardiology, McGill University Health Centre, Montreal, Quebec, Canada
Department of Cardiology, University Hospital Galway, Galway, Ireland
Martin Bergmann - Cardiologicum Hamburg, Hamburg, Germany