Table 1.

Indications for LAAO therapy

Potential indications	Examples
A. Patient not eligible for long-term OAC therapy (absolute or relative contraindications to OAC)
1. High risk for bleeding
• History of major or minor bleeding (with or without OAC therapy)	• Intracranial bleeding
	• GI bleeding
	• Symptomatic bleeding in critical organ (i.e. ocular, pericardial, spinal cord)
	• Recurrent epistaxis needing medical attention
• Increased risk for bleeding due to physical condition and/or co-morbidities	• Recurrent falls with head trauma and significant musculoskeletal injury
	• Need for additional dual antiplatelet therapy for CAD and stenting
	• Diffuse intracranial amyloid angiopathy
	• Bowel angiodysplasia
	• Severe renal insufficiency/hemodialysis
	• Blood cell dyscrasia
2. Inability to take OACs for reasons other than high risk for bleeding	• Intolerance
	• Documented poor adherence to medication
	• Documented variability in international normalized ratio on warfarin
	• Higher-risk occupation with increased injury potential
	• Patient's choice
B. Thromboembolic event or documented presence of thrombus in the LAA despite adequate OAC therapy	• Embolic stroke or other systemic thromboembolism on adequate OAC therapy with evidence for thrombus origin from the LAA (‘malignant LAA’)
	• Documented thrombus formation in the LAA on adequate OAC therapy

OAC, oral anticoagulation; GI, gastrointestinal; CAD, coronary artery disease.