Left Atrial Appendage Occlusion Devices Will Challenge Anticoagulants, Germany Report Suggests

In short

According to medtech market intelligence company Millennium Research Group (MRG), procedures for Left Atrial Appendage (LAA) devices, intended to minimize stroke risk in patients with atrial fibrillation, have grown by over 200 percent in Germany since 2010. This is perhaps unsurprising, given the company’s revelation that more than 30 percent of the physicians performing LAA procedures started to perform them only within the past year, but nevertheless it points to an underlying increase in LAA closure as a measure in stroke prevention. The company predicts that this procedure will compete for market share against the new generation of anticoagulants and uses Germany in a new report to exemplify how the market might develop.


Approximately 15 percent of all strokes are caused by atrial fibrillation, and as many as one third of strokes occurring in individuals aged 65 or older. The standard preventive treatment has long been anticoagulants, typically warfarin, in clinical use since the 1950s. Warfarin has a number of drawbacks, including excessive bleeding, dosage difficulties and frequent interactions with food and other drugs, and consequently a new raft of drugs has evolved.

Nearly 90 percent of stroke-causing thrombi in atrial fibrillation form in the left atrial appendage (LAA). Devices that close off the LAA have proved effective in minimising stroke risk.

In recent weeks and months we have covered the work being done by Boston Scientific, AtricCure and Medtronic to get their LAA occlusion devices into USA. All three companies have CE mark approval for their offerings and now have clinical trials underway in USA. LAA procedures, despite being relatively new, have been growing strongly in Germany.

MRG predicts that these procedures will be competing against the next generation of oral anticoagulants with clinical profiles significantly superior to warfarin’s.

LAA occlusion is a one time procedure vs lifelong drug therapy 

Despite improvement in anticoagulants, LAA devices are expected to continue to increase their share in this market not least because the implantation of an LAA device, whether endocardial or epicardial, is a one-time procedure, while drug therapy must be ongoing.

MRG’s new study

These results can be found in MRG’s German Left Atrial Appendage Marketrack. This study tracks LAA procedures performed, devices used, cost per unit and cost per procedure and market shares in Germany on a quarterly basis.

Source: Millennium Research Group