Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillation
Summary
Percutaneous left atrial appendage closure with an FDA-approved device, such as the Watchman or Amplatzer Amulet, may be considered medically necessary to prevent stroke in individuals with nonvalvular atrial fibrillation when they have an increased risk of stroke and systemic embolism by CHADS2 or CHA2DS2-VASc score, systemic anticoagulation is recommended, and the long-term risks of systemic anticoagulation outweigh the risks of device implantation. Individuals who do not meet these criteria are considered investigational for FDA-approved devices, and other left atrial appendage closure devices, including the Lariat and Amplatzer Cardiac Plug, are considered investigational for stroke prevention in atrial fibrillation. The balance of risks and benefits is determined on an individual basis.
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