Table 4.

Recommendation for left atrial appendage occlusion according to international guidelines.

Guidelines	Recommendation	Grade of recommendation and level of evidence
ACCP 2018 (117)	LAA occlusion has been suggested in AF patients at high risk of ischemic stroke who have absolute contraindications for OACs	Weak recommendation, low quality of evidence
Taiwan heart rhythm society 2018 (118)	Percutaneous LAA closure may be considered in patients with very high stroke risk and contraindicated for long-term OACs	No grading
Cardiac society of Australia and New Zealand 2018 (119)	LAA occlusion may be considered for stroke prevention in patients with N-VAF at moderate to high risk of stroke and with contraindication to oral anticoagulation therapy	Strong recommendation, weak quality of evidence
AHA/ACC/HRS 2019 (120)	Percutaneous LAA occlusion may be considered in patients with AF at increased risk of stroke who have contraindications to long-term anticoagulation	COR: IIb, LOE: B
CCS 2020 (121)	Percutaneous LAAO should be considered for stroke prevention in patients with NVAF who are at moderate to high risk of stroke and have an absolute contraindication to OACs	Weak recommendation, low quality of evidence
ESC 2020 (82)	LAA occlusion may be considered in patients with AF and contraindications for long-term anticoagulant treatment (e.g intracranial bleeding without a reversible cause)	COR IIb, LOE B

AF = atrial fibrillation; OACs = oral anticoagulation; LAA = left atrial appendix; LAAO = left atrial appendix occlusion; NVAF = non valvular atrial fibrillation; COR = class of recommendations; LOE = level of evidence.

Table 4 indication for left atrial appendix closure in the current guidelines.