Polish multicenter registry to assess safety and durability of totally thoracoscopic left atrial appendage occlusion for stroke prevention in atrial fibrillation.

The THORACS-LAAO Registry is the Polish multi-institutional registry of the consecutive patients with atrial fibrillation assigned for the totally thoracoscopic left atrial appendage occlusion (LAAO) for stroke prevention with designed epicardial clip AtriClip®. The registry has no limit of the number of patient included. Patients will be followed up with transoesophageal echocardiography at 6-12 months to assess the durability of left atrial appendage (LAA) oclusion and collect the informations about possible adverse events.

Inclusion Criteria:

• Age >18 years
• Lone atrial fibrillation
• Previous stroke or systemic thromboembolic complications
• High risk of thromboembolic complications assessed with CHA2DS2-VASc Score >2
• High bleeding risk assessed with HASBLED score => 2.
• Contraindications to oral anticoagulation
• Complications of the oral anticoagulation
• Acceptable surgical candidate, including use of general anaesthesia

Exclusion Criteria:

• Patient refusal
• Significant valve disease or coronary multi-vessel artery lesions requiring surgery
• Stroke/cerebrovascular accident (CVA) within previous 30 days
• Critical preoperative state

Intra-Operative Exclusion Criteria

• Presence of thrombus in the left atrium or LAA as documented on intra-operative transesophageal echocardiography
• LAA tissue with significant adhesions (as evaluated by the surgeon) carries AtriClip placement overly risky.

The registry will include all patients with atrial fibrillation with high risk of thromboembolic complications - CHA2DS2-VASc Score >2 and HASBLED score of => 2 refered to primary or secondary stroke prevention who do not require open chest surgery for other reasons.