Abstract

Atrial fibrillation is the most common form of arrhythmia, and significantly increases the risk of thromboembolic stroke. Oral anticoagulation is the mainstay of stroke risk reduction, but in some patients is contraindicated due to high bleeding risk or co-morbidities, or has proven to be ineffective. In these situations, it is possible to  perform percutaneous left atrial appendage closure for stroke prevention, in which case the appendage is isolated from circulation with an endocardially-placed mechanical closure device. Based on previous studies, this is an effective and safe procedure, but several large randomized studies are still ongoing. Post-procedure, the patient must be able to at least tolerate short-term antiplatelet therapy to prevent device-related thrombi. In Estonia, these procedures are performed in three locations. This case report is an example of the application of LAAO in a patient with atrial fibrillation, in whom oral anticoagulant therapy is contraindicated due to a high risk of bleeding.