{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T16:40:20Z","timestamp":1792600820113,"version":"4.5.0"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"Supplement_2","license":[{"start":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:00:00Z","timestamp":1792540800000},"content-version":"vor","delay-in-days":20,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008497","name":"Boston Scientific","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008497","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,21]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Pulsed field ablation (PFA) and left atrial appendage closure (LAAC) are increasingly discussed as complementary strategies in atrial fibrillation (AF) care, addressing rhythm control and long-term thromboembolic risk. The rationale is attractive, but the current evidence base is uneven. Randomized evidence for LAAC around AF ablation is strongest for thermal-ablation-era workflows, particularly the OPTION trial, which showed lower non-procedure-related major or clinically relevant non-major bleeding with LAAC than with oral anticoagulation (OAC) and non-inferiority for death, stroke, or systemic embolism. Dedicated PFA-specific evidence remains limited to feasibility studies and early observational experience, and no trial has demonstrated that combined ablation-LAAC procedures are clinically superior when the ablation component is performed with PFA rather than radiofrequency or cryoballoon ablation. In parallel, OAC-withdrawal trials after apparently successful ablation, including OCEAN and ALONE-AF, have reported low thromboembolic event rates in selected lower-risk populations, whereas CLOSURE-AF cautions against simple extrapolation of LAAC benefit to older, frailer patients at high stroke and bleeding risk. This review therefore positions combined PFA-LAAC as a potential option for carefully selected patients rather than an established routine strategy. We summarize procedural workflow, patient selection, trial populations, device-platform considerations, reimbursement and organizational issues, and the main uncertainties that should guide future prospective studies.<\/jats:p>","DOI":"10.1093\/europace\/euag202","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T11:41:06Z","timestamp":1785498066000},"page":"ii118-ii127","source":"Crossref","is-referenced-by-count":0,"title":["The perspective of combining pulsed field ablation and left atrial appendage closure"],"prefix":"10.1093","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4591-4220","authenticated-orcid":false,"given":"Lucas","family":"Boersma","sequence":"first","affiliation":[{"name":"Cardiology Department, St. Antonius Hospital Nieuwegein\/Amsterdam University Medical Centre , Nieuwegein ,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1424-114X","authenticated-orcid":false,"given":"Tom","family":"De Potter","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Centre Aalst, AZORG Aalst , Aalst ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9014-8097","authenticated-orcid":false,"given":"Christian-Hendrik","family":"Heeger","sequence":"additional","affiliation":[{"name":"Department of Rhythmology, Asklepios Clinic Altona , Hamburg ,","place":["Germany"]},{"name":"Department of Rhythmology, University of L\u00fcbeck , Lubeck ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8253-947X","authenticated-orcid":false,"given":"Devi","family":"Nair","sequence":"additional","affiliation":[{"name":"Department of Cardiac Electrophysiology and Research, St. Bernard's Heart and Vascular Center, Arrhythmia Research Group , Jonesboro, AR ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0827-1329","authenticated-orcid":false,"given":"Laurent","family":"Roten","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Inselspital, Bern University Hospital, University of Bern ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0720-3380","authenticated-orcid":false,"given":"Marco","family":"Schiavone","sequence":"additional","affiliation":[{"name":"Department of Clinical Electrophysiology and Cardiac Pacing, Centro Cardiologico Monzino, IRCCS , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8500-8313","authenticated-orcid":false,"given":"Claudio","family":"Tondo","sequence":"additional","affiliation":[{"name":"Department of Clinical 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