Arrhythmias & electrophysiology

Comparative evaluation of left atrial appendage occlusion and oral anticoagulation: a Bayesian meta-analysis of randomized controlled trials

EuropacePublished Systematic review and meta-analysis of randomised trials

Authors' conclusion

This Bayesian meta-analysis found no clear evidence supporting clinically meaningful non-inferiority of LAAO over OAC for stroke prevention. Despite reduced non-procedural bleeding, LAAO did not demonstrate a similar reduction in major bleeding.

Study context

Population
Patients with AF (stroke prevention)
Participants
7,004 patients6 RCTs
Comparison
Left atrial appendage occlusion (LAAO) vs oral anticoagulation (OAC)
Outcome
Stroke or systemic embolism (SSE), non-procedural clinically relevant bleeding (CRB) and clinical benefit composite
Methodological detailsBayesian hierarchical random effects model
  • Bayesian hierarchical random effects model

Pooled result

As reported in the abstract

LAAO vs OACRelative risk (95% CrI)
SSE; CrI; 74.6% posterior probability of favouring OAC; P(HR < 1.4) of 89% for non-inferiority
1.11(0.80–1.49)
Non-procedural CRB; CrI
0.59(0.45–0.78)
Net clinical benefit composite, contemporary trials; CrI; P(RR < 1) of 76%; substantial heterogeneity
0.90(0.51–1.50)

Original publication

Comparative evaluation of left atrial appendage occlusion and oral anticoagulation: a Bayesian meta-analysis of randomized controlled trials. Europace. Published 23 July 2026. doi:10.1093/europace/euag163

Composed by AI from the published abstract and checked against it. How Briefs are made →

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