Arrhythmias & electrophysiologyMeta-analysis
Comparative evaluation of left atrial appendage occlusion and oral anticoagulation: a Bayesian meta-analysis of randomized controlled trials
- Systematic review and meta-analysis of randomised trials
- Bayesian hierarchical random effects model
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 patients · 6 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
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
Summarised from the published abstract; every number is checked against it