Reader's Comments: Trends in the Utilization of Left Atrial Appendage Exclusion in the United States

[...]50% of high-risk NVAF patients are not maintained on oral anticoagulation due to comorbidities, frailty, bleeding complications, or noncompliance.2 In 1996, Blackshear proposed left atrial appendage exclusion (LAAE) as an alternative stroke prevention strategy in NVAF.3 Because no randomized data were available to support the routine use of LAAE, its utilization remained initially limited to selected patients undergoing a concomitant cardiac surgery. Herein, we studied a nation-level database to illustrate trends of surgical and transcatheter LAAE procedures and demographic and clinical profile of patients undergoing these procedures. More randomized data are needed to assess the efficacy of LAAE as a stroke prevention strategy in patients with NVAF in contemporary practice.Conflict of interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.