{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T23:08:30Z","timestamp":1788736110094,"version":"build-2803163510"},"reference-count":27,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thromb Haemost"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Thrombus formation in atrial fibrillation mostly occurs in the left atrial appendage (LAA). LAA closure (LAAC) seems logical to reduce thrombo-embolic AF-related stroke. Early device trials, which predominantly compared LAAC against oral anticoagulant (OAC) with warfarin, showing after 5 years less bleeding and possibly similar ischemic stroke rates with LAAC. New trials (CHAMPION-AF, OPTION, CLUSTER-AF and ASAP TOO) comparing LAAC versus direct OACs, or standard of care for the OAC-intolerant, have reported apparently discordant results, most probably related to the patient phenotype than LAAC itself. Recent meta-analyses, which include new trials have shown that overall, LAAC is followed by less clinically-relevant bleeding but more ischemic but not total strokes. Longer follow-up offsetting penalties related to the implant procedure, more expert implantation and reduced device-related thrombosis should increase the comparative value of LAAC. Meanwhile, LAAC offers therapeutic relief for OAC-intolerant patients or for those wh, understand the outcomes of LAAC and prefer device rather than medical therapy. A change in guideline recommendations should now be considered.<\/jats:p>","DOI":"10.1055\/a-2945-5484","type":"journal-article","created":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T22:31:36Z","timestamp":1788733896000},"source":"Crossref","is-referenced-by-count":0,"title":["Recent Trials of Left Atrial Appendage Closure versus Oral Anticoagulants: An Optimistic View"],"prefix":"10.1055","author":[{"given":"A. John","family":"Camm","sequence":"additional","affiliation":[{"name":"City St George's University of London, England, United Kingdom of Great Britain and Northern Ireland","place":["London"],"department":["Division of Cardiac and Vascular Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,9,6]]},"reference":[{"issue":"08","key":"ref1","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1055\/a-2688-6741","article-title":"Left atrial spontaneous echo contrast: pathogenesis, detection, and modelling","volume":"126","author":"P Melidoro","year":"2026","journal-title":"Thromb Haemost"},{"issue":"12","key":"ref2","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1055\/a-2434-9244","article-title":"The 2024 European Society of Cardiology guidelines for diagnosis and management of atrial fibrillation: a viewpoint from a practicing clinician's perspective","volume":"124","author":"T 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