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Months after the U.S. Food and Drug Administration (FDA) approved a device with the potential to close the source of many atrial fibrillation-related strokes, hospitals, cardiologists and patients find themselves in a holding pattern increasingly common for newly emerging therapies: They are waiting for the Centers for Medicare & Medicaid Services (CMS) to issue a national coverage determination for left atrial appendage (LAA) occlusion. 

As many as 6.1 million Americans are living with atrial fibrillation (afib) and the concomitant high risk for stroke. While anticoagulant medications are a proven and viable option for reducing stroke risk faced by most of these patients, about 40 percent can’t or won’t take warfarin or one of the newer oral anticoagulants (JAMA 2014;312[19...

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