Percutaneous left atrial appendage closure: here to stay

Stroke prevention has long been perceived as the Achilles heel in the management of atrial fibrillation (AF). In recent years, percutaneous left atrial appendage (LAA) closure, a novel catheter-based therapy designed to occlude the primary nidus responsible for cardioembolic events is emerging as a safe and effective alternative, amidst the multiple limitations encountered with conventional oral anticoagulants (OAC), particularly warfarin (1). Long-term use of warfarin, albeit efficacious (2), is often overshadowed by the need for continuous monitoring and dose adjustments, narrow therapeutic window, food and drug interactions, and most importantly undesirable bleeding hazards. The introduction of direct OAC remains inadequate to address these shortcomings due to the persistent major bleeding complications (3-5).