Sealing the left atrial appendage: Ready for prime time?

Atrial fibrillation (AF) is the most common sustained arrhythmia and a leading cause of stroke. Warfarin reduces the incidence of thromboemboli and is recommended for most patients with AF. However, oral anticoagulation is contraindicated or not tolerated by a significant percentage of patients with AF. Occlusion of the left atrial appendage, the major source of emboli in atrial fibrillation, has been shown to be a potential alternative to warfarin in patients with AF who have contraindications to anticoagulation. In this article, we describe the current percutaneous left atrial appendage occlusion devices, their safety in recent trials, and their potential role in stroke prevention in AF.