Atrial fibrillation (AF) is one of the most prevalent arrythmias worldwide and associated with an increased risk of stroke and systemic thromboembolism. Stroke prevention with direct oral anticoagulation (DOAC) is recommended in patients with non-valvular AF (NVAF) at high risk of stroke. WATCHMAN TM percutaneous left atrial appendage closure (LAAC) device is currently introduced as an alternative to DOAC for patients with NVAF ineligible for long-term administration of DOAC due to high risk of

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... bleeding. This review article may contribute to recognize the paradigm shift in which stroke prevention should be carried out topically but not systemically, because left atrial appendage (LAA) is the main source of thrombus formation in AF patients. In addition, this review article introduces the current knowledge and future perspective of LAAC strategy and technology.