Left atrial appendage occlusion as a therapeutic strategy for atrial fibrillation

Atrial fibrillation (AF) is one of the most common arrthymias. AF places patients at increased risk of thromboembolism, in particular ischemic stroke. The left atrial appendage (LAA) is a site of major blood stasis during AF, increasing the risk of thrombus formation and stroke; 90% of thrombus formation in nonvalvular AF is in the LAA. Therefore, percutaneous LAA exclusion is an evolving treatment to prevent embolic events in patients with nonvalvular AF. Oral anticoagulation (OAC) has been shown to significantly reduce the risk of thromboembolism in numerous studies. Traditional OAC, such as warfarin, has many limitations including constant monitoring, slow onset and offset of action, inter-individual variability in anticoagulant effect, narrow therapeutic index, and food and drug interactions. Therefore, closure of the LAA might provide an alternative strategy to chronic warfarin therapy for stroke prophylaxis in patients with non-valvular atrial fibrillation.