Non-valvular atrial fibrillation (NVAF) affects more than 12 million Americans, conferring a 5-fold increase in stroke risk due to thromboembolism.

The well-established use of oral anticoagulation (OAC) in NVAF has been codified in previous multisociety guidelines; however, less than two-thirds of patients with NVAF are treated with OAC due to reasons including bleeding, fall risk, medication non-adherence, medication cost, and patient preference.

Transcatheter LAAO is a procedural alternative to OAC that similarly lowers the risk of NVAF-associated stroke. More than 30,000 LAAO procedures are performed each year in the United States, however, considerable variation in real-world clinical practice remains.

In the setting of an expanding evidence base, SCAI and HRS collaborated to conduct an original systematic review and to formulate rigorous multisociety LAAO guidelines using GRADE methodology.

Topics covered include patient selection, pre-, intra-, and postprocedural imaging, and management of peridevice leak and device-related thrombus.

All authors: Andrew M. Goldsweig, MD, MS, FSCAI(Chair); Michael Glikson, MD; Jacqueline Joza, MD, FHRS; Clifford J. Kavinsky, MD, PhD, MSCAI; Omar Khalique, MD, FSCAI; Dhanunjaya Lakkireddy, MD, FHRS; G. Burkhard Mackensen, MD, PhD, FSCAI; Gerald V. Naccarelli, MD, FHRS; Devi G. Nair, MD, FHRS; Jacqueline Saw, MD, FSCAI; Rahul Prakash Sharma, MD, FSCAI; Matthew Sherwood, MD, FSCAI; Molly Szerlip, MD, FSCAI; Yngve Falck-Ytter, MD; Rebecca L. Morgan, PhD, MPH; Chelsea Armah, MPH; Scott Firestone, MS; Angela Fix, MPH, MWC; Emily Senerth, MS, MPH; and Christopher R. Ellis, MD, FHRS (Co-Chair).