Exclusion of the left atrial appendage (LAA) to reduce thromboembolic risk related to atrial fibrillation (AF) was first performed surgically in 1949. Over the past 2 decades, transcatheter endovascular LAA closure (LAAC) has rapidly expanded with a myriad of devices approved or in clinical development. The number of LAAC cases performed in the US and worldwide has increased exponentially since the Food and Drug Administration (FDA) approval of the WATCHMAN (Boston Scientific, Marlborough, Massachusetts) device in 2015.

SCAI previously published statements in 2015 and 2016 providing a societal overview of the technology and institutional and operator requirements for LAAC. Since then, results from several important clinical trials and registries have been published, technical expertise and clinical practice have matured over time, and the device and imaging technologies have evolved.

Therefore, SCAI and the Heart Rythm Society prioritized the development of an updated consensus statement to provide recommendations on contemporary, evidence-based best practices for transcatheter LAAC focusing on endovascular devices.

All authors: Jacqueline Saw, MD, FSCAI (Chair); David Holmes, MD, FSCAI (Vice-Chair); João L. Cavalcante, MD; James V. Freeman, MD, MPH, MS; Andrew M. Goldsweig, MD, MS, FSCAI; Clifford Kavinsky, MD, PhD, MSCAI; Issam Moussa, MD, MBA, FSCAI; Thomas Munger, MD; Matthew Price, MD, FSCAI; Mark Reisman, MD, FSCAI; Matthew William Sherwood, MD, MHS, FSCAI; Zoltan Turi, MD, MSCAI; Dee Dee Wang, MD, FSCAI; and Brian Whisenant, MD, FSCAI.