Left Atrial Appendage Occlusion and Stroke Risk in Patients with AF Undergoing Other Cardiac Surgery

Observational studies have suggested that left atrial appendage occlusion (LAAO) in patients undergoing surgery would reduce the long-term risk for stroke, but these studies have likely contained residual bias. The current researchers randomized some 4800 adults (68% men) who had a history of atrial fibrillation and were at risk for stroke (CHA₂DS₂-VASc score, ≥2) to undergo or not undergo left atrial appendage occlusion during cardiac surgery for another indication. All patients were expected to receive usual care, including anticoagulation, during the study, and investigators and patients were blinded as to whether LAAO was performed.

During a mean follow-up of 3.8 years, risk for stroke or systemic embolism was significantly lower in pati…