Abstract
Summary Atrial fibrillation (AF) patients are at inherent risk for thromboembolic stroke. Since the left atrial appendage (LAA) is known to be the primary site for thrombus formation in nonvalvular AF, its exclusion may offer an attractive alternative to long-term oral anticoagulation therapy in such patients. Accordingly, simultaneous LAA closure became common practice during cardiac surgery and was recently adopted by surgical guidelines. Alternatively, while thoracoscopic epicardial occlusion under general anaesthesia has been successfully performed, the actual breakthrough came with the introduction of transcatheter LAA exclusion in 2001. Although this device technology was beset with initial difficulties which even led to withdrawal of the original device line, several events in the recent past have revived interest in this catheter-based technology as a valid and safe option for stroke prevention in AF patients. This review discusses the relation of the LAA to the development of AF-related stroke and provides detailed insight into different transcatheter devices for LAA occlusion.
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