Does Left Atrial Appendage Ligation Improve Outcomes of Atrial Fibrillation Ablation?

A nonrandomized study suggested some benefit of left atrial appendage (LAA) ligation in patients undergoing atrial fibrillation (AF) ablation. This result led to a randomized, controlled trial comparing the safety and efficacy of LAA ligation plus pulmonary vein isolation (PVI) versus PVI alone in patients undergoing ablation for symptomatic, nonparoxysmal AF (NCT02513797). The trial was funded by the manufacturer of the ligation device used in the trial (LARIAT), which is not FDA-approved for this specific indication, but rather soft tissue closure.

Approximately 400 patients underwent LAA ligation plus PVI and 206 underwent PVI alone. Acute PVI procedural success (i.e., isolation of all pulmonary veins) occurred in 94% in both groups. Ther…