Platelet-activation and Optimal Inhibition in Patients With Atrial Fibrillation Undergoing Left Atrial Appendage Occlusion

Inclusion Criteria:

• The subject is aged 18 years or older
• The subject is accepted/scheduled for left atrial appendage occlusion
• The subject has a CHA₂DS₂-VASc Score ≥2 (male) or ≥3 (female)
• The subject or legal representative is able to understand and is willing to providewritten informed consent to participate in the trial.

Exclusion Criteria:

• Unable or unwilling to return for required follow-up visits and examinations
• Mechanical heart valves or valvular disease requiring surgery or interventionalprocedure
• Ongoing major bleeding or complicated or recent (<72hours) major surgery
• Known large oesophageal varices or decompensated liver disease (unless a documentedpositive opinion of a gastro-enterologist)
• Severe thrombocytopenia (<50,000/ml)
• High likelihood of being unavailable for follow-up or psycho-social condition makingstudy participation impractical.
• Woman with child bearing potential who do not use an efficient method ofcontraception.
• Positive serum or urine pregnancy test for woman with child bearing potential
• Pregnancy or within 48 hours post-partum
• unsuitable LAA anatomy for occlusion or thrombus in the LAA at the time of procedure
• contraindications or unfavourable conditions to perform cardiac catheterization ortransesophageal echocardiography (TEE)
• atrial septal malformations, atrial septal defect or a high-risk patent foramen ovalethat may cause thrombo-embolic events
• atrial septal defect repair or closure device or a patent foramen ovale repair or anyother anatomical condition as this may preclude an LAAO procedure
• Mitral valve regurgitation grade 3 or more
• Aortic valve stenosis (AVA<1.0 cm2 or Pmax>50 mmHg) or regurgitation grade 3 or more
• Planned carotid endarterectomy (CEA) for significant carotid artery disease
• Life expectancy of less than 1 year