Can cardioversion be safely performed for recurrent atrial fibrillation in patients who have undergone left atrial appendage clipping during CABG, if they are not on chronic anticoagulation anymore?

Based upon the LAAOS III trial, we know that patients with left atrial appendage ligation at the time of cardiac surgery have a lower risk of stroke compared to those who did not when anticoagulation is continued in both groups. The data is much less clear for complete cessation of anticoagulation after surgical appendage ligation compared to percutaneous left atrial appendage procedures. For both surgical ligation and percutaneous closure procedures, there is not a great deal of data and practice varies widely with regards to anticoagulation around the time of cardioversion. In general, unless there are strict contraindications for anticoagulation, I continue it indefinitely in the surgical ligation population, and I definitely continue/st...

I agree with those who wrote about continued caution following surgical LAAO.