Percutaneous left atrial appendage laa closure is an emerging technology for thromboembolic prevention in patients with atrial fibrillation af the first human implantation of an laa device occurred in 2001 and since then four devices have received ce mark approval these devices are being. The percutaneous closure of the left atrial appendage versus warfarin therapy for prevention of stroke in patients with atrial fibrillation protect af trial 50 51 was a multicentre randomized non inferiority trial designed to demonstrate safety and efficacy of the watchman device against warfarin therapy in nonvalvular af patients with . Left atrial appendage closure a percutaneous transcatheter approach for stroke prevention in atrial fibrillation accordingly new approaches for stroke prevention in these patients are being explored and tested in transoesophageal echocardiographic tee studies more than 90 of thrombi were found in the left atrial appendage laa in . The clinical impact of incomplete left atrial appendage closure with the watchman device in patients with atrial fibrillation a protect af percutaneous closure of the left atrial appendage versus warfarin therapy for prevention of stroke in patients with atrial fibrillation substudy j am coll cardiol 2012 59 923 9. Formation regarding the central role of left atrial appendage laa thrombus has led to mechanical approaches for stroke prevention in this setting a number of catheter and surgical based strategies have been studied10 16 with the exception of one randomizedclinicaltrial17themajorityoftheinfor
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