Left Atrial Appendage Closure: A Safe and Effective Alternative to Anticoagulation?

To date, left atrial appendage closure (LAAC) devices continue to be assessed as an intuitive alternative to oral anticoagulant therapy to prevent embolic complications in patients with atrial fibrillation. Concerns remain about the up-front risks associated with device implantation as well as device efficacy in preventing embolic events as compared with anticoagulation. Currently, LAAC devices serve as a potential alternative to long-term anticoagulation with the benefit of decreased bleeding risk but with less protection against ischemic events. An individualized risk-benefit analysis with regard to stroke possibility, bleeding likelihood with long-term anticoagulation, the risks of an invasive procedure, and the risks associated with having a lifelong intracardiac device should be performed to guide careful patient selection for this operation.