Percutaneous Left Atrial Appendage Closure: Rational, Patient Selection, and Preoperative Evaluation

Atrial fibrillation (AF) is the most common arrhythmia, affecting 1–2 % of worldwide population, the incidence is 0.05 % cases per year, and it is expected to more than double by 2050 in the western countries [1]. AF presence increases the risk of embolic stroke by four- to fivefold [2] and results in stroke incidence of 2–5 % per year in untreated patients [3]. Such disabling complication is mainly related to thrombus formation within the left atrial appendage (LAA) [4]. Furthermore, among patients with AF and history of stroke, the rate of new embolic events may increase up to 12 % per year if patients are not on oral anticoagulants and is at 3 % per year in patients who are properly under medical treatment [2].