Intracardiac Versus Transesophageal Echocardiographic Guidance for Left Atrial Appendage Occlusion

Eligibility Criteria

• 1. Patients diagnosed for non-valvular atrial fibrillation with documented paroxysmal, persistent, or permanent NVAF.
• 2. Deemed to be at high risk of stroke or systemic embolism (SE) defined as a CHADS2 score ≥2 or a CHA2DS2-VASc score ≥3.
• 3. Patient suitable for OAC with warfarin or DOAC and have appropriate rationale to seek a nonpharmacologic alternative to long-term OAC, meeting commercial LAAO criteria indications.
• 4. Can undergo appropriate pre-procedural imaging with Computed tomography (CT) or transesophageal echocardiography (TEE).
• 5. Patient should be able to comply with the protocol.
• 6. Provide written informed consent before study participation.
• 7. Ages 18 and above
• 1. Presence of an intracardiac thrombus on the preprocedural TEE or CT.
• 2. History of previously implanted device for atrial septal defect or patent foramen ovale.
• 3. Severe LV dysfunction (LVEF \< 40%) or greater than moderate valvular heart disease.
• 4. Enrollment in another study that competes or interferes with this study. Approval to dual enroll must be approved by the other study.
• 5. Poor clinical condition like cardiogenic shock, which prohibits pre- and post-procedural function tests.
• 6. Subject with planned cardiac intervention between the time of consenting and up to 60 days post-LAAO.
• 7. Any other condition or co-morbidity which, in the opinion of the investigator or operator, may pose a significant hazard to the subject if he or she is enrolled in the study.
• 8. For women of childbearing potential: Pregnant or breastfeeding women or planning pregnancy during the course of the investigation are excluded due to the risks involved in the procedure
• 9. Children below 18 years, prisoners and patients who are unable to provide consent are excluded.