Evidence mapPaperPMID 40549033Full record

SynthesisClinical research in cardiology : official journal of the German Cardiac Society2026

Comparison of left atrial appendage occlusion with medical treatment for non-valvular atrial fibrillation: systematic review, network and reconstructed individual patient data meta-analysis.

Tsahi T Lerman, Roy Hershenson, Noam Greenberg, Mark Kheifets, Yeela Talmor-Barkan, Pablo Codner, Leor Perl, Guy Witberg, Aviad Rotholz, Shelly Vons and 7 more

Abstract readSystematic ReviewMeta-AnalysisComparative Study
PubMed Publisher
In one paragraph

Synthesis in Clinical research in cardiology : official journal of the German Cardiac Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Tsahi T LermanDepartment of Cardiology, Rabin Medical Center, 39 Jabotinski St., 49100, Petah Tikva, Israel. tsahilerman@gmail.com.ORCID http://orcid.org/0000-0002-2491-9930
Roy HershensonDepartment of Cardiology, Rabin Medical Center, 39 Jabotinski St., 49100, Petah Tikva, Israel.
Noam GreenbergThe Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Mark KheifetsDepartment of Cardiology, Rabin Medical Center, 39 Jabotinski St., 49100, Petah Tikva, Israel.
Yeela Talmor-BarkanDepartment of Cardiology, Rabin Medical Center, 39 Jabotinski St., 49100, Petah Tikva, Israel.
Pablo CodnerDepartment of Cardiology, Rabin Medical Center, 39 Jabotinski St., 49100, Petah Tikva, Israel.
Leor PerlDepartment of Cardiology, Rabin Medical Center, 39 Jabotinski St., 49100, Petah Tikva, Israel.
Guy WitbergDepartment of Cardiology, Rabin Medical Center, 39 Jabotinski St., 49100, Petah Tikva, Israel.
Aviad RotholzDepartment of Cardiology, Rabin Medical Center, 39 Jabotinski St., 49100, Petah Tikva, Israel.
Shelly VonsDepartment of Cardiology, Rabin Medical Center, 39 Jabotinski St., 49100, Petah Tikva, Israel.
Katia OrvinDepartment of Cardiology, Rabin Medical Center, 39 Jabotinski St., 49100, Petah Tikva, Israel.
Alon EisenDepartment of Cardiology, Rabin Medical Center, 39 Jabotinski St., 49100, Petah Tikva, Israel.
David BelkinThe Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Boris FishmanThe Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Gregory GolovchinerDepartment of Cardiology, Rabin Medical Center, 39 Jabotinski St., 49100, Petah Tikva, Israel.
Ran KornowskiDepartment of Cardiology, Rabin Medical Center, 39 Jabotinski St., 49100, Petah Tikva, Israel.
Amos LeviDepartment of Cardiology, Rabin Medical Center, 39 Jabotinski St., 49100, Petah Tikva, Israel.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPercutaneous left atrial appendage occlusion (LAAO) is a non-pharmacological strategy to prevent stroke and systemic emboli in patients with non-valvular atrial fibrillation (AF). However, data regarding its safety and efficacy profile compared to different oral anti-coagulant regimens remain limited.

methodsA network meta-analysis compared LAAO, warfarin, and NOACs (standard dose [SD] and low-dose [LD]). Outcomes included all-cause mortality, stroke or systemic embolism, and bleeding risk. Bayesian models with surface under the cumulative ranking curve (SUCRA) and reconstructed individual patient data (IPD) were utilized.

resultsTwelve studies, including eight randomized controlled trials, were analyzed (13,049 patients with LD NOAC, 29,513 with SD NOAC, 29,611 with warfarin, and 2811 with LAAO). Warfarin was inferior for all-cause mortality compared to LAAO (OR 1.44 [95% CrI; 1.07-1.89]), LD NOAC (OR 1.13 [95% CrI; 1.01-1.26]), and SD NOAC (OR 1.11 [95% CrI; 1.02-1.20]). SUCRA analysis ranked SD NOAC as the most effective for stroke or systemic emboli prevention, LD NOAC as the most effective in preventing major bleeding and LAAO in preventing hemorrhagic stroke.

conclusionsSD NOACs were the most effective for preventing stroke or systemic embolism, while LD NOACs were the safest in terms of major bleeding. LAAO was comparable to NOACs and superior to warfarin in both safety and efficacy. Further studies are needed to clarify LAAO's role in the management of atrial fibrillation.

Indexed as

AnticoagulantsAtrial AppendageAtrial FibrillationStrokeWarfarinGlobal HealthHumansNetwork Meta-Analysis as TopicTreatment OutcomeAnticoagulantsWarfarinAtrial fibrillationLeft atrial appendage occlusionMajor bleedingNon-vitamin K oral anticoagulantsStroke prevention

Identifiers

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.