Left atrial appendage closure devices. Their role in 2013.

Stroke prevention is the major goal in treating patients with atrial fibrillation. Warfarin therapy, if used appropriately, is highly effective in preventing thromboembolic events, but is simultaneously burdened by a narrow therapeutic window, multiple food and drug interactions, and a substantial bleeding risk. New pharmacological agents show only a modest reduction of bleeding complications compared to warfarin. Percutaneous device left atrial appendage (LAA) closure has now been technologically advanced as an additional and potential alternative to pharmacotherapy in patients with AF. Promising randomized data are obtainable with the WATCHMAN® device, while several other devices are in various stages of clinical and preclinical development. In this article we review the current knowledge and status of this technique.