{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T10:26:59Z","timestamp":1790245619869,"version":"4.1.0"},"reference-count":27,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T00:00:00Z","timestamp":1781827200000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Arrhythmia"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>While oral anticoagulants (OACs) remain the cornerstone of stroke prevention, left atrial appendage closure (LAAC) is a potential alternative, particularly for patients with high bleeding risk or contraindications to long\u2010term anticoagulation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Multiple databases were searched to identify relevant randomized controlled trials (RCTs), and four trials were shortlisted. Study selection, data extraction, and quality assessment were performed independently by two reviewers. Outcomes assessed included stroke (all, ischemic, hemorrhagic), systemic embolism, major bleeding, non\u2010procedure\u2010related bleeding, and mortality. Risk of bias was evaluated using Rob 2.0, and meta\u2010analyses were conducted using RevMan software. Dichotomous outcomes were reported as risk ratios (RR) while continuous outcomes were reported as mean differences (MD), with 95% confidence intervals (CIs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 3116 participants were analyzed across outcomes. LAAC significantly reduced non\u2010procedure\u2010related bleeding (RR: 0.48, 95% CI: 0.37\u20130.61;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.00001) and all\u2010cause mortality (RR: 0.74, 95% CI: 0.55\u20130.99;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04). A marginal reduction was observed in the composite outcome of stroke, systemic embolism, or death (RR: 0.77, 95% CI: 0.59\u20131.00;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.05). No significant differences were found for major bleeding (RR: 0.82, 95% CI: 0.56\u20131.22), all strokes (RR: 0.84, 95% CI: 0.56\u20131.25), ischemic stroke (RR: 1.15, 95% CI: 0.72\u20131.85), hemorrhagic stroke (RR: 0.46, 95% CI: 0.11\u20132.02), systemic embolism (RR: 1.52, 95% CI: 0.36\u20136.41), or cardiovascular\/unexplained death (RR: 0.60, 95% CI: 0.29\u20131.23).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>LAAC offers a viable alternative to standard anticoagulation in selected AF patients with comparable efficacy and a particular benefit in reducing non\u2013procedure\u2010related bleeding and mortality advantages.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/joa3.70382","type":"journal-article","created":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T05:14:04Z","timestamp":1781932444000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Left Atrial Appendage Closure vs. Oral Anticoagulation in Patients With Atrial Fibrillation: An Updated Systematic Review and Meta\u2010Analysis of Randomized Controlled Trials"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-7082-8564","authenticated-orcid":false,"given":"Chika","family":"Chilaka","sequence":"first","affiliation":[{"name":"Lagos State University  Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hassan Dawood","family":"Khan","sequence":"additional","affiliation":[{"name":"Rashid Latif Medical College  Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Uzair","family":"Sarfraz","sequence":"additional","affiliation":[{"name":"King Edward Medical University  Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zainab","family":"Farooq","sequence":"additional","affiliation":[{"name":"Punjab Rangers Teaching Hospital  Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ebaad","family":"Hassan","sequence":"additional","affiliation":[{"name":"Allama Iqbal Medical College  Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rabeea","family":"Sabir","sequence":"additional","affiliation":[{"name":"Allama Iqbal Medical College  Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saman","family":"Siddique","sequence":"additional","affiliation":[{"name":"Jinnah Postgraduate Medical Center  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nimra","family":"Zahid","sequence":"additional","affiliation":[{"name":"National Hospital and Medical Center  Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mujeeb Ur","family":"Rehman","sequence":"additional","affiliation":[{"name":"Khyber Teaching Hospital  Peshawar Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Salih","sequence":"additional","affiliation":[{"name":"Dow University Hospital  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4601-2851","authenticated-orcid":false,"given":"Mohammad","family":"Umer","sequence":"additional","affiliation":[{"name":"King Edward Medical University  Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1722-3926","authenticated-orcid":false,"given":"Asma'a Munasar Ali","family":"Alsubari","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Sana'a University  Sana'a Yemen"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6021-2342","authenticated-orcid":false,"given":"Muhammad","family":"Ehsan","sequence":"additional","affiliation":[{"name":"King Edward Medical University  Lahore 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