Table 2.

Concluding remarks.

Patients with nonvalvular AF have a 4- to 5-fold increase in strokes and that rhythm may be responsible for 15% to 20% of all strokes, particularly in the elderly.

Unresolved issues include 1) Optimal patient selection criteria; 2) The role of devices in patients in whom anticoagulation is contraindicated, and; 3) The relative role of novel oral anticoagulants versus the device which has not been tested in randomized trials.

For LAA procedures relevant anatomic spatial relationships have to be emphasized.

There was the early controversy that the critical role of the LAA in normal physiological functioning may be eliminated with LAA procedures.

LAA closure during routine cardiac surgery was significantly associated with an increased risk of early POAF but did not influence the risk of stroke or mortality. It remains uncertain whether prophylactic exclusion of LAA is warranted for stroke prevention during non-AF-related cardiac surgery.

AF=atrial fibrillation; LAA=left atrial appendage; POAF=preoperative atrial fibrillation