The Lead Episode 152: A Discussion of Outcomes of Left Atrial Appendage Closure versus Oral Anticoagulation in Patients with Atrial Fibrillation and Prior Ablation: A Sub-Analysis of the CHAMPION-AF Clinical Trial (Heart Rhythm Journal)

This April 2026 Heart Rhythm Journal publication reports a sub-analysis of the CHAMPION-AF trial evaluating left atrial appendage closure (LAAC) versus oral anticoagulation in patients with atrial fibrillation who previously underwent catheter ablation. The analysis demonstrated that LAAC with the WATCHMAN FLX device provided comparable protection against stroke, systemic embolism, and cardiovascular death when compared with NOAC therapy, while also reducing long-term non-procedural bleeding events. These findings support consideration of LAAC as an alternative stroke prevention strategy in selected post-ablation AF patients through individualized, shared decision-making.

Digital Education Committee Member Danesh Kella, MBBS, FHRS discusses this article from the Heart Rhythm Journal that preceded the Heart Rhythm 2026 Late-Breaking Clinical Trial. He is joined in the conversation by Jason T. Jacobson, MD, FHRS, Ammar M. Killu, MBBS, and Gregory M. Marcus, MD, FHRS.

Learning Objectives

Describe the rationale for left atrial appendage closure as an alternative to chronic oral anticoagulation in patients with atrial fibrillation after catheter ablation.
Review the efficacy and safety outcomes from the CHAMPION-AF sub-analysis comparing LAAC and NOAC therapy in post-ablation AF patients.
Discuss patient selection considerations and the role of shared decision-making when choosing stroke prevention strategies following AF ablation.

Podcast Contributors

Danesh Kella, MBBS, FHRS
Jason T. Jacobson, MD, FHRS
Ammar M. Killu, MBBS
Gregory M. Marcus, MD, FHRS

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The Lead Episode 152: A Discussion of Outcomes of Left Atrial Appendage Closure versus Oral Anticoagulation in Patients with Atrial Fibrillation and Prior Ablation: A Sub-Analysis of the CHAMPION-AF Clinical Trial (Heart Rhythm Journal)

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The Lead Episode 151: Heart Rhythm 2026 Late-Breaker Coverage: A Discussion of Outcomes of Left Atrial Appendage Closure versus Oral Anticoagulation in Patients with Atrial Fibrillation and Prior Ablation: A Sub-Analysis of the CHAMPION-AF Clinical Trial

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