Current evidence suggests that percutaneous occlusion of the left atrial appendage (LAA) is efficacious in reducing the risk of thromboembolic complications associated with non-valvular atrial fibrillation (AF).
Dear Mariana. Although the association of both thecnique is not usual, I think that is a good perspective to interventional treatment of patients with AF and high risk of thromboembolism. After established the definitive criteria for inclusion of patients, the procedure will be used more frequently.
I think these two therapeutics has 2 maily different goals as AF ablation was first of all designed to reduce symptomes of AF and LAA occlusion was designded mainly to reduce thrombo embolic complications.
Many patients who are candidates for AF ablation have a low risk of thrombo embolic events and no contre indication for anticoagulants so the association of the two therapeutics should be considered very rarely
I disagree that AF ablation is designed to reduce symptoms. The control of symptoms is possible with drug therapy, but not avoid the thromboembolism.
For the ones who are interested in this topic you might also take a look at our article:
J Am Heart Assoc. 2012 Oct;1(5):e002212. doi: 10.1161/JAHA.112.002212. Epub 2012 Oct 25.
Swaans et al - Ablation for atrial fibrillation in combination with left atrial appendage closure: first results of a feasibility study.
We need consistent information to recommend percutaneous LAA occlusion in unselected patients. Moreover when NOACs are now available with a better risk profile for major bleeds.
And in my opinion, the risk of procedural is an unfinished task.
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