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Percutaneous atrial appendage occlusion for stroke prevention in patients with atrial fibrillation: a systematic review
  1. Stine Munkholm-Larsen1,2,
  2. Christopher Cao2,
  3. Tristan D Yan2,
  4. Steen Pehrson1,3,
  5. Ulrik Dixen1,4
  1. 1The University of Copenhagen, Copenhagen, Denmark
  2. 2The Systematic Review Group, The Baird Institute for Applied Heart and Lung Surgical Research, Sydney, Australia
  3. 3Department of Cardiology, Rigshospitalet, Copenhagen, Denmark
  4. 4Hvidovre University Hospital, Copenhagen, Denmark
  1. Correspondence to Tristan D Yan, MBBS, MD, PhD The Systematic Review Group, The Baird Institute for Applied Heart and Lung Surgical Research, Sydney, Australia; tristanyan{at}


This review aims to evaluate systematically the safety and efficacy of percutaneous left atrial appendage occlusion (PLAAO) in stroke prevention for patients with atrial fibrillation (AF). A systematic review of peer-reviewed journals on PLAAO before June 2011 was performed on three electronic databases. Fourteen studies were identified for evaluation. Overall, implantation was successful in 93% of all cases. Periprocedural mortality and stroke rates were 1.1% and 0.6%, respectively. The incidences of pericardial effusion/cardiac tamponade and device embolisation were 4% and 0.7%, respectively. At the time of the latest follow-up (up to 40 months), the overall incidence of stroke among all studies was 1.4% per annum. Existing evidence suggests that PLAAO is a relatively safe treatment for patients with AF. However, there is a need for further evaluation of its efficacy in the form of large and well-designed randomised controlled trials.

  • Amplatzer cardiac plug
  • atrial fibrillation
  • coronary artery disease
  • left atrial appendage closure
  • left atrial appendage occlusion
  • minimally invasive
  • surgery—coronary bypass
  • surgery—valve
  • watchman device

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  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.