Annual report on transcatheter left atrial appendage closure in 2024_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 BAI Yuan ¹ , ZHANG Xiaochun ² , ZENG Jie ³ , WU Yongjian ⁴ , ZHOU Daxin ² , Representatives of Structural Cardiology Committee of Cardiovascular Physicians Branch of Chinese Medical Doctor Association , National Clinical Research Center for Interventional Medicine , China Heart House

1. Department of Cardiology, Changhai Hospital, Navy Military Medical University, Shanghai, 200433, P. R. China;
2. Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, P. R. China;
3. Department of Cardiology, Sichuan Provincial People's Hospital, Chengdu, 610072, P. R. China;
4. Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, 100037, P. R. China;

Corresponding author：

BAI Yuan, Email: yuanbai@smmu.edu.cn

Keywords：

Transcatheter left atrial appendage closure; interventional therapy; atrial fibrillation; annual report

DOI：

10.7507/1007-4848.202503024

Video：

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After two decades of development, transcatheter left atrial appendage closure has emerged as a safe and effective intervention for stroke prevention in patients with atrial fibrillation. In 2024, significant advancements were made in the field of left atrial appendage closure in terms of evidence-based medicine, device research and development, and guideline consensus. The annual report on transcatheter left atrial appendage closure systematically reviews global academic progress in 2024, encompassing newly published clinical evidence, recently developed occlusion devices, and updated international guidelines/consensus statements. In the future, the development direction of transcatheter left atrial appendage closure mainly includes expanding surgical indications, optimizing imaging assistance technology, improving closure device design, and exploring individualized strategies for postoperative antithrombotic therapy.

1.	Wazni OM, Saliba WI, Nair DG, et al. Left atrial appendage closure after ablation for atrial fibrillation. N Engl J Med, 2025, 392(13): 1277-1287.
2.	Kapadia SR, Yeh RW, Price MJ, et al. Outcomes with the WATCHMAN FLX in everyday clinical practice from the NCDR Left Atrial Appendage Occlusion Registry. Circ Cardiovasc Interv, 2024, 17(9): e013750.
3.	Kar S, Doshi SK, Sadhu A, et al. Primary outcome evaluation of a next-generation left atrial appendage closure device: Results from the PINNACLE FLX trial. Circulation. 2021, 143(18):1754-1762.
4.	Freixa X, Cruz-González I, Cepas-Guillén P, et al. Low-dose direct oral anticoagulation vs dual antiplatelet therapy after left atrial appendage occlusion: The ADALA randomized clinical trial. JAMA Cardiol, 2024, 9(10): 922-926.
5.	Reinhardt SW, Gibson DN, Hsu JC, et al. Anticoagulation alone vs anticoagulation plus aspirin or DAPT following left atrial appendage occlusion. J Am Coll Cardiol, 2024, 84(10): 889-900.
6.	Antúnez-Muiños P, López-Tejero S, Cepas-Guillén P, et al. A comparison of simplified or conventional antithrombotic regimens after left atrial appendage closure in patients at high bleeding risk: The PLATEBRISK study. EuroIntervention, 2024, 20(16): 1018-1028.
7.	Aarnink EW, Maarse M, Fierro N, et al. Left atrial appendage occlusion in patients with anticoagulation failure vs anticoagulation contraindication. JACC Cardiovasc Interv, 2024, 17(11): 1311-1321.
8.	Aglan A, Fath AR, Maron BJ, et al. Percutaneous left atrial appendage closure for stroke prevention in hypertrophic cardiomyopathy patients with atrial fibrillation. Heart Rhythm, 2024, 21(9): 1677-1683.
9.	Zhang T, Gao C, Liu J, et al. Impact of operator experience on left atrial appendage occlusion outcomes. JACC Clin Electrophysiol, 2024, 10(11): 2461-2470.
10.	Friedman DJ, Du C, Zimmerman S, et al. Procedure volume and outcomes with WATCHMAN left atrial appendage occlusion. Circ Cardiovasc Interv, 2024, 17(6): e013466.
11.	Du X, Chu H, Yang B, et al. Strategy optimization for a combined procedure in patients with atrial fibrillation: The COMBINATION randomized clinical trial. JAMA Netw Open, 2024, 7(11): e2445084.
12.	Zhang S, Xiong S, Zhang S, et al. WATCHMAN versus LACbes® device for percutaneous left atrial appendage closure: A single-center, propensity-matched study. BMC Cardiovasc Disord, 2025, 25(1): 18.
13.	Van Gelder IC, Rienstra M, Bunting KV, et al. 2024 ESC guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J, 2024, 45(36): 3314-3414.
14.	Korsholm K, Iriart X, Saw J, et al. Position statement on cardiac computed tomography following left atrial appendage occlusion. JACC Cardiovasc Interv, 2024, 17(15): 1747-1764.
15.	中华医学会心电生理和起搏分会, 中国医师协会心律学专业委员会, 左心耳封堵工作委员会. 左心耳干预预防心房颤动患者血栓栓塞事件: 目前的认识和建议(2023). 中华心律失常学杂志, 2023, 27(6): 463-489.Chinese Society of Pacing and Electrophysiology, Chinese Society of Arrhythmias, Working Committee on Occlusion of Left Atrial Appendage. Left atrial appendage intervention to prevent thromboembolic events in patients with atrial fibrillation: Current knowledge and recommendations (2023). Chin J Cardiac Arrhyth, 2023, 27(6): 463-489.
16.	储慧民, 杜先锋. 心腔内超声心动图指导左心耳封堵的规范化标准流程. 中华心脏与心律电子杂志, 2024, 12(1): 1-5.Chu HM, Du XF. The standard protocol of intracardiac echocardiography-guided left atrial appendage closure. Chin J Heart Heart Rhythm (Electron Ed), 2024, 12(1): 1-5.
17.	Wang Z, Chu H, Chen X, et al. Percutaneous left atrial appendage closure with SeaLA device in non-valvular atrial fibrillation. Catheter Cardiovasc Interv, 2024, 104(7): 1491-1498.
18.	Chen M, Yao PC, Fei ZT, et al. Prognostic impact of left atrial appendage patency after device closure. Circ Cardiovasc Interv, 2024, 17(5): e013579.
19.	Yao PC, Fei ZT, Chen M, et al. Incidence, impact and predictors of residual device patency after left atrial appendage closure with the LACbes device. Int J Cardiol, 2024, 397: 131640.

1. Wazni OM, Saliba WI, Nair DG, et al. Left atrial appendage closure after ablation for atrial fibrillation. N Engl J Med, 2025, 392(13): 1277-1287.
2. Kapadia SR, Yeh RW, Price MJ, et al. Outcomes with the WATCHMAN FLX in everyday clinical practice from the NCDR Left Atrial Appendage Occlusion Registry. Circ Cardiovasc Interv, 2024, 17(9): e013750.
3. Kar S, Doshi SK, Sadhu A, et al. Primary outcome evaluation of a next-generation left atrial appendage closure device: Results from the PINNACLE FLX trial. Circulation. 2021, 143(18):1754-1762.
4. Freixa X, Cruz-González I, Cepas-Guillén P, et al. Low-dose direct oral anticoagulation vs dual antiplatelet therapy after left atrial appendage occlusion: The ADALA randomized clinical trial. JAMA Cardiol, 2024, 9(10): 922-926.
5. Reinhardt SW, Gibson DN, Hsu JC, et al. Anticoagulation alone vs anticoagulation plus aspirin or DAPT following left atrial appendage occlusion. J Am Coll Cardiol, 2024, 84(10): 889-900.
6. Antúnez-Muiños P, López-Tejero S, Cepas-Guillén P, et al. A comparison of simplified or conventional antithrombotic regimens after left atrial appendage closure in patients at high bleeding risk: The PLATEBRISK study. EuroIntervention, 2024, 20(16): 1018-1028.
7. Aarnink EW, Maarse M, Fierro N, et al. Left atrial appendage occlusion in patients with anticoagulation failure vs anticoagulation contraindication. JACC Cardiovasc Interv, 2024, 17(11): 1311-1321.
8. Aglan A, Fath AR, Maron BJ, et al. Percutaneous left atrial appendage closure for stroke prevention in hypertrophic cardiomyopathy patients with atrial fibrillation. Heart Rhythm, 2024, 21(9): 1677-1683.
9. Zhang T, Gao C, Liu J, et al. Impact of operator experience on left atrial appendage occlusion outcomes. JACC Clin Electrophysiol, 2024, 10(11): 2461-2470.
10. Friedman DJ, Du C, Zimmerman S, et al. Procedure volume and outcomes with WATCHMAN left atrial appendage occlusion. Circ Cardiovasc Interv, 2024, 17(6): e013466.
11. Du X, Chu H, Yang B, et al. Strategy optimization for a combined procedure in patients with atrial fibrillation: The COMBINATION randomized clinical trial. JAMA Netw Open, 2024, 7(11): e2445084.
12. Zhang S, Xiong S, Zhang S, et al. WATCHMAN versus LACbes® device for percutaneous left atrial appendage closure: A single-center, propensity-matched study. BMC Cardiovasc Disord, 2025, 25(1): 18.
13. Van Gelder IC, Rienstra M, Bunting KV, et al. 2024 ESC guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J, 2024, 45(36): 3314-3414.
14. Korsholm K, Iriart X, Saw J, et al. Position statement on cardiac computed tomography following left atrial appendage occlusion. JACC Cardiovasc Interv, 2024, 17(15): 1747-1764.
15. 中华医学会心电生理和起搏分会, 中国医师协会心律学专业委员会, 左心耳封堵工作委员会. 左心耳干预预防心房颤动患者血栓栓塞事件: 目前的认识和建议(2023). 中华心律失常学杂志, 2023, 27(6): 463-489.Chinese Society of Pacing and Electrophysiology, Chinese Society of Arrhythmias, Working Committee on Occlusion of Left Atrial Appendage. Left atrial appendage intervention to prevent thromboembolic events in patients with atrial fibrillation: Current knowledge and recommendations (2023). Chin J Cardiac Arrhyth, 2023, 27(6): 463-489.
16. 储慧民, 杜先锋. 心腔内超声心动图指导左心耳封堵的规范化标准流程. 中华心脏与心律电子杂志, 2024, 12(1): 1-5.Chu HM, Du XF. The standard protocol of intracardiac echocardiography-guided left atrial appendage closure. Chin J Heart Heart Rhythm (Electron Ed), 2024, 12(1): 1-5.
17. Wang Z, Chu H, Chen X, et al. Percutaneous left atrial appendage closure with SeaLA device in non-valvular atrial fibrillation. Catheter Cardiovasc Interv, 2024, 104(7): 1491-1498.
18. Chen M, Yao PC, Fei ZT, et al. Prognostic impact of left atrial appendage patency after device closure. Circ Cardiovasc Interv, 2024, 17(5): e013579.
19. Yao PC, Fei ZT, Chen M, et al. Incidence, impact and predictors of residual device patency after left atrial appendage closure with the LACbes device. Int J Cardiol, 2024, 397: 131640.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

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