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Evidence to Improve Care

Left Atrial Appendage Closure Device With Delivery System

Ontario Health Technology Advisory Committee Recommendation

  • The Ontario Health Technology Advisory Committee recommends that the left atrial appendage closure device with delivery system be publicly funded for patients with nonvalvular atrial fibrillation in whom all oral anticoagulants are contraindicated

Read the Full Ontario Health Technology Advisory Committee Recommendation Report Here



Atrial fibrillation is a common heart disease involving an irregular heart rhythm, known as an arrhythmia. Nonvalvular atrial fibrillation, atrial fibrillation that does not involve the heart valves, is the most common form of atrial fibrillation and can lead to stroke. In Ontario, stroke is the third-leading cause of death and the leading cause of disability in adults. The rate of stroke in people with atrial fibrillation is three to five times higher than in those without atrial fibrillation, and about 15% to 20% of those who have experienced stroke have nonvalvular atrial fibrillation.

In people with nonvalvular atrial fibrillation who experience stroke, the blood clots causing stroke arise from the left atrial appendage, a small sac in the muscle of the heart’s left atrium, in 90% of cases.

Stroke can be prevented in people with nonvalvular atrial fibrillation with medications such as novel oral anticoagulants or devices such as a left atrial appendage closure device with delivery system.


Health Quality Ontario Reviews the Left Atrial Appendage Closure Device With Delivery System

We assessed the effectiveness and cost-effectiveness of a left atrial appendage closure device with delivery system versus novel oral anticoagulants and oral antiplatelet medications in patients with nonvalvular atrial fibrillation.

The left atrial appendage closure device with delivery system is a minimally invasive alternative to treatment with oral anticoagulants for patients with nonvalvular atrial fibrillation. The device closes the left atrial appendage, which reduces the risk of blood clot formation.


Left Atrial Appendage Closure Device With Delivery System: A Health Technology Assessment
July 2017

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The Ministry of Health and Long-Term Care is currently reviewing this recommendation.



Health Technology Assessment at Health Quality Ontario

As part of our core function to promote health care supported by the best available evidence, we use established scientific methods to analyze the evidence for a wide range of health interventions, including diagnostic tests, medical devices, interventional and surgical procedures, health care programs and models of care. These analyses are informed by input from a range of individuals, including patients and clinical experts. The Ontario Health Technology Advisory Committee (OHTAC) — a committee of the Health Quality Ontario board of directors — reviews the evidence and makes recommendations about whether health care interventions should be publicly funded or not. Draft recommendations are posted on the Health Quality Ontario website for feedback. Final recommendations are approved by our board of directors and then shared with the Ministry of Health and Long-Term Care. For more detailed information, visit our Evidence to Improve Care pages.


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