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 (initial published materials)
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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.
  • 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 
All relevant financial relationships have been mitigated.

Host and Contributor Disclosure(s):

J.T. Jacobson

•Board/Advisory Committee Membership: Abbott Medical
•Honoraria/Speaking/Teaching/Consulting: Zoll Medical Corporation, Vektor Medical, Inc.
•Research: CardioFocus, Inc., Johnson and Johnson
•Stocks, Privately Held: Atlas 5D



D. Kella

•Honoraria/Speaking/Teaching/Consulting: Zoll Medical Corporation, MBW Spectrum


A. Killu

•Board/Advisory Committee Membership: Boston Scientific
•Honoraria/Speaking/Teaching/Consulting: AtriCure, Inc., Abbott, Biosense Webster, Inc., Siemans Healthineers
•Research: Boston Scientific, Access Point Technologies


G.M. Marcus

•Honoraria/Speaking/Teaching/Consulting: InCarda Therapeutics
•Research: NIH, PCORI, TRDRP
•Stocks, Publicly Traded: InCarda Therapeutics


Staff Disclosure(s) (note: HRS staff are NOT in control of educational content. Disclosures are provided solely for full transparency to the learner):

S. Sailor: No relevant financial relationships with ineligible companies to disclose.