Ján Šípka, Peter Bačík
Atrial fibrillation (AF) is the most common cardiac arrhythmia in clinical practice. Ischemic stroke is the most dangerous
consequence of AF. In case of AF there is a blood stasis in the left atrium and cardiac thrombi can form. Embolisation of
thrombi is the cause of an acute thromboembolic event, which is usually ischemic stroke. Pathological, anatomical and
echocardiographic findings confirm that thrombi originate in the left atrial appendage in about 90 % of cases of non-valvular
AF. Nowadays anticoagulation treatment (warfarin and novel anticoagulants) is the most effective prevention of
thromboembolic events in AF patients, showing a significant risk reduction in comparison with placebo. Haemorrhagic
complications are the common limitation of widespread using of anticoagulation treatment. In some cases haemorrhage
could be the contraindication of anticoagulant treatment. For AF patients with a contraindication of anticoagulation
treatment and high thromboembolic risk, there is currently the possibility to consider left atrial appendage closure.
In this paper we discuss the kind of patients that should be considered as candidates for left atrial appendage closure.