Stroke prevention with percutaneous left atrial appendage closure

Abstract

Atrial fibrillation (AF) is the most common cardiac arrhythmia with increasing prevalence. AF is associated with considerable morbidity and mortality. Cardioembolic stroke results as a consequence of thrombus formation within the left atrial appendage (LAA) in patients with AF and has a significant impact on our health system. Oral anticoagulation with either vitamin K antagonists or the novel anticoagulants is an effective medical therapy for prophylaxis against strokes in patients suffering from AF. Unfortunately, bleeding complications and compliance issues limit their use. A need for newer approaches have thereby been developed and studied such as percutaneous occlusion of the LAA. Several LAA occlusion devices have been developed, and with improved operator experience, they have been successful in stroke prevention in patients with nonvalvular AF and fewer periprocedural complications. This article reviews the use of percutaneous LAA occlusion devices in the prevention of cardioembolic stroke.