This report is the third update of a systematic review compiled in 2011 and evaluates the efficacy and safety of left atrial appendage closure (LAAC) either using percutaneous LAAC devices or a surgically implanted special clip compared to oral anticoagulation (OAC) for stroke prevention in patients with atrial fibrillation.

The currently available evidence is not sufficient to prove that the percutaneous LAAC is as effective and as safe as OAC. Especially comparative studies on non-vitamin K oral anticoagulants (NOACs) are missing. For LAAC with the surgically implanted special clip, there is no evidence that allows an evaluation of efficacy and safety.

At present, the inclusion into the Austrian hospital benefit catalogue is not recommended for both interventions. A re-evaluation is proposed in 2023.