Reddy VY, et al. - Analyzing pooled, long-term data from the randomized PROTECT AF and PREVAIL trials, researchers investigated the cost-effectiveness of left atrial appendage closure relative to both warfarin and non-warfarin oral anticoagulants (NOACs) for stroke reduction in atrial fibrillation. They constructed a Markov model from a US payer perspective with a lifetime (20-year) horizon and populated it with a cohort of 10,000 patients, aged 70 years, at a moderate risk for stroke and bleeding. The left atrial appendage closure was identified as cost-effective and cost-saving relative to non-warfarin oral anticoagulants and warfarin, even with the increased risk of ischemic stroke observed in the PREVAIL trial, when all the randomized controlled trial data was considered. For patients with atrial fibrillation seeking an alternative to lifelong anticoagulation, left atrial appendage closure with the Watchman device is identified as an economically feasible strategy to reduce stroke risk.