Commentaries
Vol. 5 No. 4 (2026)
When is percutaneous left atrial appendage closure a valid alternative to oral anticoagulation in atrial fibrillation?
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Published: 16 October 2026
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Three recent randomized trials have attempted to address the question on whether left atrial appendage closure (LAAC) is a valid alternative to oral anticoagulant treatment in patients with atrial fibrillation (AF): the OPTION trial, the CLOSURE-AF trial and the CHAMPION-AF trial.
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Citations
1.Wazni OM, Saliba WI, Nair DG, et al. Left atrial appendage closure after ablation for atrial fibrillation. N Engl J Med 2025;392:1277-87. DOI: https://doi.org/10.1056/NEJMoa2408308
2.Landmesser U, Skurk C, Kirchhof P, et al. Left atrial appendage closure or medical therapy in atrial fibrillation. N Engl J Med 2026;394:1270-80. DOI: https://doi.org/10.1056/NEJMoa2513310
3.Doshi SK, Kar S, Nair DG, et al. Left atrial appendage closure or anticoagulation for atrial fibrillation. N Engl J Med 2026;394:2083-94. DOI: https://doi.org/10.1056/NEJMoa2517213
4.Kim D, Shim J, Choi E, et al. Long-term anticoagulation discontinuation after catheter ablation for atrial fibrillation: the ALONE-AF randomized clinical trial. JAMA 2025;334: 1246-54. DOI: https://doi.org/10.1001/jama.2025.14679
5.Van Gelder IC, Rienstra M, Bunting KV, et al. 2024 ESC Guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J 2024;45:3314-414. DOI: https://doi.org/10.1093/eurheartj/ehae176
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How to Cite
1.
Pengo V. When is percutaneous left atrial appendage closure a valid alternative to oral anticoagulation in atrial fibrillation?. Bleeding Thromb Vasc Biol [Internet]. 2026 Oct. 16 [cited 2026 Oct. 21];5(4). Available from: https://www.btvb.org/btvb/article/view/570
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