Many patients with atrial fibrillation (AF) who are in need of stroke prevention are not treated with oral anticoagulation or discontinue treatment shortly after its initiation. Despite the availability of direct oral anticoagulants (DOACs), such undertreatment has improved somewhat but is still evident. This is due to continued risks of bleeding events or ischemic strokes while on DOAC, poor treatment compliance, or aversion to anticoagulant therapy. Because of significant improvements in procedural safety over the years left atrial appendage closure (LAAC), using a catheter-based, device implantation approach, is increasingly favored for the prevention of thromboembolic events in AF patients who cannot have long-term oral anticoagulation. This article is an executive summary of a practical guide recently published by an international expert consensus group, which introduces the LAAC devices and briefly explains the implantation technique. The indications and device follow-up are more comprehensively described. This practical guide, aligned with published guideline/guidance, is aimed at those non-implanting physicians who may need to refer patients for consideration of LAAC.

1st Department of Cardiology Poznan University School of Medical Sciences Poznan Poland

Aarhus University Hospital Aarhus Denmark

Berlin Institute of Health Center for Regenerative Therapies Berlin Germany Deutsches Herzzentrum der Charité Campus Virchow Klinikum Berlin Germany

Brussels University VUB Brussels Belgium

Cardioangiologisches Centrum Bethanien Agaplesion Markus Krankenhaus Frankfurt Germany

Cardioangiology Center Bethanien CCB Frankfurt Germany; Center for Vascular Research Munich Germany

Cardiology Department St Antonius Hospital Nieuwegein Amsterdam University Medical Centers The Netherlands

Cardiology Division Department of Biomedical Metabolic and Neural Sciences University of Modena and Reggio Emilia Policlinico di Modena Modena Italy

Cardiology Heart Rhythm Management Department Clinique Pasteur Toulouse France

Cardiovascular Center Aalst OLV Hospital Aalst Belgium

Department of Cardiology Angiology and Intensive Care Medicine Deutsches Herzzentrum Charité Charité University Medicine Berlin Friede Springer Cardiovascular Prevention Center Berlin Germany

Department of Cardiology University Heart and Vascular Centre Hamburg Hamburg Germany

Department of Cardiology University Hospital Kralovske Vinohrady Charles University Prague Czech Republic

Department of Clinical Electrophysiology and Cardiac Pacing Department of Biomedical Surgical and Dental Sciences Centro Cardiologico Monzino IRCCS University of Milan Milan Italy

Department of Clinical Medicine Danish Center for Health Services Research Aalborg University Aalborg Denmark

Department of Neurology Universitätsklinikum Würzburg Würzburg Germany

Department of Surgery Oncology and Gastroenterology University Hospital of Padua Padua Italy

Division of Cardiology European Georges Pompidou Hospital AP HP Paris France

Division of Nephrology EuDial Working Group of the European Renal Association Miull General Hospital Acquaviva delle Fonti Italy

European Interbalkan Medical Centre Aristotle University of Thessaloniki Ippokrateio Hospital of Thessaloniki Thessaloniki Greece

German Centre for Cardiovascular Research Partner Site Berlin Charité Universitätsmedizin Berlin Berlin Germany

German Centre for Cardiovascular Research Partner Site Hamburg Kiel Lübeck Hamburg Germany

German Heart Center Charite Campus Mitte Berlin Germany

Leicester NIHR BRU University of Leicester Glenfield Hospital Leicester United Kingdom

Liverpool Centre for Cardiovascular Science at University of Liverpool Liverpool John Moores University and Liverpool Heart and Chest Hospital Liverpool United Kingdom

Medical Faculty University of Belgrade University Clinical Centre of Serbia Belgrade Serbia

Nephrology and Dialysis Unit Italian Society of Nephrology ASL Toscana NordOvest Livorno Italy

Ospedale del Cuore Fondazione CNR Regione Toscana G Monasterio Pisa Italy

School of Medicine and Surgery Nephrology Clinic Monza Italy and Istituto Auxologico Italiano University of Milano Bicocca IRCCS Milan Italy

St George's University of London London United Kingdom

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