Evaluating Mortality and Bleeding Risk After Percutaneous Left Atrial Appendage Closure in Atrial Fibrillation: A Propensity-Matched Analysis Using a Multi-Institutional Database

Percutaneous left atrial appendage closure (pLAAC) has emerged as an effective treatment strategy for stroke prevention in patients with atrial fibrillation (AF) who otherwise cannot tolerate anticoagulation (AC) therapy. The American College of Cardiology, American Heart Association, American College of Chest Physicians, and Heart Rhythm Society combined guidelines offer a class 2a recommendation to pursue pLAAC in patients with an elevated risk of stroke from AF and a contraindication to oral AC, and a class 2b recommendation for pLAAC in patients with elevated risk of stroke from AF and elevated risk of life-threatening bleeding from AC.1 The predominant pLAAC device on the market currently is the Watchman implant (Boston Scientific, St. Paul, Minnesota), which has been shown to be non-inferior to oral AC for stroke prevention in multiple landmark trials.2