Review ArticlesLeft Atrial Appendage Occlusion in the Management of Stroke in Patients With Atrial FibrillationOjo, Amole MD*; Yandrapalli, Srikanth MD†; Veseli, Granit MD†; Karim, Mohammad MD†; Aronow, Wilbert S. MD†; Sharma, Mala MD†; Frishman, William H. MD‡; Naidu, Srihari S. MD†; Jacobson, Jason T. MD†; Iwai, Sei MD†Author Information From the *Division of Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA †Division of Cardiology, New York Medical College/Westchester Medical Center, Valhalla, NY ‡Department of Medicine, New York Medical College/Westchester Medical Center, Valhalla, NY. Disclosure: The authors have no conflicts of interest to report. Correspondence: Sei Iwai, MD, Westchester Medical Center, 100 Woods Road, Macy Pavilion- Cardiology, Valhalla, NY 10595. E-mail: firstname.lastname@example.org. Cardiology in Review: January/February 2020 - Volume 28 - Issue 1 - p 42-51 doi: 10.1097/CRD.0000000000000240 Buy Metrics Abstract Atrial fibrillation (AF) is associated with a substantially higher risk of thromboembolism, particularly stroke events, resulting in significant morbidity and mortality. Oral anticoagulation (OAC), while effective in reducing embolic events in AF patients, is associated with an increased bleeding risk. Thus, not all patients with AF are candidates for OAC and some are only candidates for OAC in the short term. Of the available nonpharmacologic strategies for the management of AF, left atrial appendage occlusion (LAAO) has emerged as a potential approach for reducing the risk of systemic thromboembolism in AF patients eligible for OAC. LAAO can be achieved either surgically or percutaneously using an epicardial, endocardial, or a combined approach. Although available data are limited, currently available LAAO devices, and those being developed, have shown promise in reducing bleeding risk in AF patients because of the reduced overall need for anticoagulation, while maintaining efficacy in preventing thromboembolism. The optimal device will reduce both embolic and hemorrhagic strokes, and other bleeds, with a high implant success rate and a low complication rate. Until that time, anticoagulation remains the gold standard that these devices strive to surpass, and thus LAAO devices are currently indicated in patients with relative contraindication to OAC therapy. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.