Abstract
Objectives: Stroke prevention in atrial fibrillation (AF) may be achieved by elimination of AF itself, prevention of clot formation by medical therapy and physical elimination of the left atrial appendage (LAA), the site of clot formation. Elimination of AF has actually not been effective against stroke, probably because no AF therapy has been able to suppress all AF episodes. Anticoagulant therapy is effective, but is limited by bleeding, patient non-compliance, suboptimal anticoagulation control and need for therapy discontinuation during lifelong treatment. Occlusion of the LAA is a logical idea that has received considerable recent attention due to positive results from a small trial of device closure.
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