LAAC Noninferior to NOACs in Anticoagulation-Eligible AF

CHAMPION-AF extends left atrial appendage closure into patients who are fully eligible for oral anticoagulation, demonstrating noninferior thromboembolic protection with substantially less non-procedural bleeding at 3 years.

left atrial appendage closureWatchman FLXNOACDOACatrial fibrillationstroke preventionanticoagulationbleedingCHAMPION-AFrandomized controlled trialdevice therapy Cardiology / Anticoagulation

Background Information

Atrial appendage closure reduces bleeding in atrial fibrillation.

Choosing between left atrial appendage closure and anticoagulation is crucial for preventing stroke in atrial fibrillation patients. Device-based closure was noninferior for cardiovascular events and superior for reducing non-procedure-related bleeding compared to NOACs. This study suggests left atrial appendage closure as a viable alternative to NOACs for suitable atrial fibrillation patients, reducing bleeding risks. Left atrial appendage closure offers similar efficacy with less bleeding compared to NOACs.

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Authors: Doshi SK, Kar S, Nair DG, Waggoner T, Agarwal H, Moussavian M, Kashani A, Oza S, Feldman L, Sadhu A, DeLurgio D, Alli O, Nielsen-Kudsk JE, Yamamoto M, Alkhouli M, Camm AJ, Coylewright M, Gibson CM, Granger CB, Gurol ME, Huber KC, Mansour M, Natale A, Pocock SJ, Reddy VY, Saliba WI, Asch FM, Wehrenberg S, Frost K, Christen T, Sutton BS, Stein KM, Leon MB, Ellenbogen KA, CHAMPION-AF Investigators

Citation: Doshi SK, Kar S, Nair DG, et al. Left Atrial Appendage Closure or Anticoagulation for Atrial Fibrillation. The New England journal of medicine. 2026;394(21):2083-2094. doi:10.1056/NEJMoa2517213

Article Links: PubMed · Journal / DOI

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Executive Summary

Study Design

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Secondary Outcomes & Safety Profile

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