Left Atrial Appendage Occlusion Device

Oral anticoagulants such as warfarin, factor Xa inhibitors, and direct thrombin inhibitors are the current standard of care in high-risk patients with atrial fibrillation to reduce the risk of stroke in patients with risk factors, albeit at the expense of an increase in bleed. However, the benefit of oral anticoagulation needs to be weighed against an increased risk of bleeding.

Left atrial appendage occlusion devices have the potential to change the therapy for stroke prevention in atrial fibrillation patients. ACC/HRS/SCAI have just published an overview of the literature on this topic. The overview reviews several questions related to the use of these occlusion devices. The overview starts with literature review of currently available devices (WATCHMAN, Amplatzer Cardiac Plug, LARIAT, and others) and then delves into the question of the need and requirements for care team and facilities needed for the use of such devices. This is followed by training requirement for the operator, standardization of protocols, and selection of patients for occlusion device placement. The overview is an interesting read and is available here.