Key result
LAAC reduces non-procedural bleeding and proves non-inferior to OAC for major events post-AF ablation.
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Why the study?
To evaluate event rates of left atrial appendage closure versus oral anticoagulation after catheter ablation in relation to baseline stroke risk.
Does left atrial appendage closure reduce bleeding and prevent death, stroke, or systemic embolism compared to oral anticoagulation in patients following atrial fibrillation ablation?
RCT (n=1,600)
Does left atrial appendage closure reduce bleeding and prevent death, stroke, or systemic embolism compared to oral anticoagulation in patients following atrial fibrillation ablation?
In a sub-analysis of the OPTION trial, cardiovascular event rates were low following AF ablation among individuals with a CHA [text truncated].
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“In patients at both high and lower stroke risk, LAA closure was equally effective as oral anticoagulation while being associated with fewer bleeding events. This means that LAA closure can be an especially good option for ablation patients at high risk of stroke if they discontinue oral anticoagulation due to bleeding.”
“This most recent analysis of OPTION is important because it demonstrates effective stroke prevention and less bleeding in patients who received the LAAC device, including those at highest risk. As a physician, I can now offer LAAC with confidence to my patients undergoing AF ablation who are unable to remain on blood thinners long term.”
“The OPTION trial sub-analysis reinforces the role of the Watchman FLX device as a safe and effective alternative to long-term anticoagulation after AF ablation, regardless of a patient's stroke risk. Together, these data reflect our dedication to generating robust clinical evidence and continuously refining our solutions to make a meaningful difference in patient outcomes worldwide.”
May support risk-stratified antithrombotic decisions post-AF ablation; leaves open confirmatory trials across CHA2DS2-VASc strata.
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Healey et al. (2026) conducted an RCT in Atrial fibrillation (n=1,600). Left atrial appendage closure (LAAC) vs. Oral anticoagulation (OAC) was evaluated on Composite of death, stroke, or systemic embolism (efficacy) and non-procedural major or clinically relevant non-major bleeding (safety). Left atrial appendage closure reduced non-procedural bleeding and was non-inferior to oral anticoagulation for death, stroke, or systemic embolism at 3 years following atrial fibrillation ablation.
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