 I am Dr. Ranjan Shetty, I head cardiology department at Manipal Hospital old airport road. Atrial fibrillation is the most common arrhythmia. In this condition, the heart beats very irregularly. So the upper chamber beats and the lower chamber beats but the upper chamber beats is very very irregular, it does not contract now, it just starts shaking. This condition is common at age of 60, 1-2% will have AF and at 80, 5-8% will have AF. The biggest problem of AF is not irregular heart rate, it is actually the stroke it produces. Because now upper chamber is not actually contracting, it is just shaking, the blood can become stagnant especially in an area called left atrial appendage, clots can form and it can lead to stroke. Stroke or paralysis is a very dangerous condition and stroke produced by atrial fibrillation is much more risky, it is more disabling, it is mortality is higher. To prevent this, typically a blood thinner is given. These blood thinners are stronger than aspirin, they are 10 times more stronger. So once you give this blood thinner, chance of clot formation decreases tremendously and stroke risk comes down. But unfortunately because these blood thinners are very strong, people do not take it for some reason and even when they take it has to be taken for life, most of the time twice a day. In time to come, the medicine is stopped, it needs to be interrupted for procedures, dental extraction or any surgery. So many of the people who need this therapy will not receive it. So there is an alternative for this, that alternative is called left atrial appendage closure. In this condition, the clot more than 90% is actually formed in one single area called left atrial appendage, you close it off, then the patient does not need strong blood thinner and stroke risk reduces by 95%. It is a very effective therapy, it is FDA approved and DCJA approved and procedure is done through the groin vein, no it is done under local anesthesia and whichever area which is the one which can produce the clot is the area which is closed with a small device. These devices are similar to the device which we use in children for closure of the holes in the heart, it is a technically simple procedure with success more than 97%. Once you successfully implant the device, strong blood thinners come out of, they need not use the strong blood thinner, they could be in light blood thinner like aspirin beyond this. Generally typically patients feel comfortable taking these drugs and they are happy that they could avoid stronger blood thinner. There are many heart diseases which are present and there are many many people now who tend to suffer with lot of heart disease, we are here to tell that there are some minimal practically minimally invasive options, these are more minimal than the surgical minimal, these are just a single puncture which is put in the groin or a hand, so we are able to do many procedures which were earlier done by open heart surgery which was earlier done by surgeons. The procedures which we are able to do now are valve replacement for aortic valve called as TAVI, extensively done now available in most centers now, Mitra Clip which is done for mitral valve, left atrial appendage closure which is now done as alternative to anti-cogulation to AF. Along with this there are other minimally invasive procedures which can be done which includes ballooning of mitral valve, aortic valve or tricuspid valve, it also includes series of angioplasty and day by day even very complex angioplasty are also being done in a very minimally invasive way.