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Review
. 2024 Mar 6:13:e01.
doi: 10.15420/aer.2024.08. eCollection 2024.

Left Atrial Appendage Occlusion: British Cardiovascular Intervention Society and British Heart Rhythm Society Position Statement

Tim R Betts  1 , Patrick A Calvert  2 , Lee N Graham  3 , Gerald J Clesham  4 , Ashan Gunarathne  5 , Brian Clapp  6 , Dhiraj Gupta  7 , Jan Kovac  8 , James D Newton  9 , David Hildick-Smith  10
Affiliations
Review

Left Atrial Appendage Occlusion: British Cardiovascular Intervention Society and British Heart Rhythm Society Position Statement

Tim R Betts et al. Arrhythm Electrophysiol Rev. .

Abstract

Percutaneous left atrial appendage occlusion aims to reduce the risk of stroke in patients with AF, particularly those who are not good candidates for systemic anticoagulation. The procedure has been studied in large international randomised trials and registries and was approved by the National Institute for Health and Care Excellence in 2014 and by NHS England in 2018. This position statement summarises the evidence for left atrial appendage occlusion and presents the current indications. The options and consensus on best practice for pre-procedure planning, undertaking a safe and effective implant and appropriate post-procedure management and follow-up are described. Standards regarding procedure volume for implant centres and physicians, the role of multidisciplinary teams and audits are highlighted.

Keywords: AF; Left atrial appendage; NICE guidance; anticoagulation; stroke.

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Conflict of interest statement

Disclosure: TRB has received honoraria from Boston Scientific, and is a member of the Clinic Events Committee for Boston Scientific Clinical Trials. PAC has received honoraria from Abbott, and is Chair of the British Cardiovascular Intervention Society Structural Heart Disease Research Group. BC has received honoraria from Abbott Medical and support from Boston Scientific to attend meetings. GJC has received payment for expert reports for coroners' inquests in the UK, is a Data Safety Monitoring Board member for the ORBITA CTO trial, and is honorary secretary of British Cardiovascular Intervention Society. DG has received honoraria from Abbott Medical. DH has received honoraria from Abbott, Boston and Eclipse. JK has received grants and honoraria from Boston Scientific and Abbott Vascular, and is Immediate Past Chair of the ESC Council for Stroke. JDN has received honoraria from Abbott Medical UK. All other authors have no conflicts of interest to declare. The primary publication of this British Cardiovascular Intervention Society and British Heart Rhythm Society position statement is published in Interventional Cardiology: Reviews, Research, Resources, the official journal of the British Cardiovascular Intervention Society (https://doi.org/10.15420/icr.2023.42).

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