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Left atrial appendage occlusion in atrial fibrillation: contemporary techniques, clinical outcomes, and future directions
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Published: 2 November 2026
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Left atrial appendage occlusion (LAAO) is an important strategy for stroke prevention in patients with non-valvular atrial fibrillation (AF) who have contraindications to long-term oral anticoagulation. We differentiate this review from existing literature by integrating recent controversial trial data and device-specific outcomes. Advances in technology and imaging have transformed LAAO into a widely adopted percutaneous therapy. Large trials and registries demonstrate LAAO’s non-inferiority to oral anticoagulants. For example, the PRAGUE-17 trial (N=402) found LAAO non-inferior to direct oral anticoagulants, while PROTECT-AF and PREVAIL 5-year data (N=1114) showed significant reductions in hemorrhagic stroke. The surgical LAAOS III trial (N=4811) demonstrated a 33% longterm reduction in stroke or systemic embolism. Major complications have declined; the SURPASS registry (N=16,446) demonstrated a 0.51% incidence of pericardial effusion for the WATCHMAN FLX. In the Amulet IDE trial, pericardial effusion occurred in 2.4% of Amulet patients versus 1.2% of WATCHMAN patients. Recent 2026 NEJM trials (CHAMPION-AF and CLOSURE-AF) reached opposite conclusions in different populations, remaining a central controversy. Emerging technologies like artificial intelligence-guided planning, which accurately predicted device size in 72.7% of cases, and low-thrombogenic devices continue to improve safety. This review summarizes contemporary techniques, imaging, complications, outcomes, and future directions.
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How to Cite
1.
Siddiqi AK, Aaqil SI, Sohail S, Mohammad S, Mithani A, Ayub MT, et al. Left atrial appendage occlusion in atrial fibrillation: contemporary techniques, clinical outcomes, and future directions. Global Cardiol [Internet]. 2026 Nov. 2 [cited 2026 Nov. 4];. Available from: https://www.globalcardiology.info/site/article/view/121
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