[Left atrial appendage occlusion for atrial fibrillation].

Embolic stroke is the most dangerous complication of atrial fibrillation (AF). Oral anticoagulation represents the treatment of choice for thromboembolic (TE) prophylaxis in patients with a CHADS2VASc score ≥ 1 but is associated with a significant increase in haemorrhagic events. Almost 90 % of thrombi originate in the left atrial appendage. Registries have shown that percutaneous occlusion of this appendage reduces embolic risk and may be considered for TE prophylaxis in patients with a high TE (CHADS2VASc score ≥ 2) and haemorrhagic (HAS-BLED score ≥ 3) risk. However, available randomized trials of this technique did not include patients with contraindication to oral anticoagulants.