SCAI/HRS Expert Consensus Statement on Transcatheter Left Atrial Appendage Closure

JACC Cardiovasc Interv. 2023 Jun 12;16(11):1384-1400. doi: 10.1016/j.jcin.2023.01.011. Epub 2023 Mar 27.

Abstract

Exclusion of the left atrial appendage to reduce thromboembolic risk related to atrial fibrillation was first performed surgically in 1949. Over the past 2 decades, the field of transcatheter endovascular left atrial appendage closure (LAAC) has rapidly expanded, with a myriad of devices approved or in clinical development. The number of LAAC procedures performed in the United States and worldwide has increased exponentially since the Food and Drug Administration approval of the WATCHMAN (Boston Scientific) device in 2015. The Society for Cardiovascular Angiography & Interventions (SCAI) has previously published statements in 2015 and 2016 providing societal overview of the technology and institutional and operator requirements for LAAC. Since then, results from several important clinical trials and registries have been published, technical expertise and clinical practice have matured over time, and the device and imaging technologies have evolved. Therefore, SCAI prioritized the development of an updated consensus statement to provide recommendations on contemporary, evidence-based best practices for transcatheter LAAC focusing on endovascular devices.

Keywords: CHA(2)DS(2)-VASc; device-related thrombus; embolic stroke prevention; left atrial appendage closure; non-valvular atrial fibrillation; peridevice leak.

Publication types

  • Practice Guideline

MeSH terms

  • Angiography
  • Atrial Appendage* / diagnostic imaging
  • Atrial Fibrillation* / diagnostic imaging
  • Atrial Fibrillation* / therapy
  • Humans
  • Stroke* / etiology
  • Stroke* / prevention & control
  • Treatment Outcome