 Atrial fibrillation is a very common disease especially in elderly, above 60 years of age 1 to 2% has atrial fibrillation. In this disease the upper chamber of the heart which we call as atria now doesn't beat but it starts vibrating and the lower chamber continues to beat. Since the lower chamber continues to beat usually there is no threat to life but because the upper chamber is now vibrating rather than beating this chance that the clot can form and this clot could go to brain and they could sustain a major stroke or paralysis. Now all of us realize this is a very serious condition and undetected this leads to a major stroke. Stroke produced by atrial fibrillation are more dangerous than the other strokes they are more deadly they you know take more life and also the residual damage is much higher. So to prevent this there are blood thinners which are given which we call as oral anticoagulation. Earlier they were drugs called warfarein or acetrom. Now there are newer drugs which are called direct oral inhibitor which are recommended for patients with atrial fibrillation. Left atrial appendage closure is a procedure which is done like angiogram where we go from the groin we use the femoral vein and with that we read the right atrium and make a septal puncture and then we will go to the left atrium. Majority of the clot in atrial fibrillation actually come from one area in left atrium which is called the left atrial appendage. This structure is like appendix it doesn't have a normal physiological function but it can produce lots of harm especially in atrial fibrillation. So we close of this area using a device. Now there are two devices which are approved in India for this procedure. Now who should undergo this procedure? It is probably atrial fibrillation patient who cannot take anticoagulation for whatever reason they have ulcer, they have bleeding tendencies or they tend to fall repeatedly or they have renal failure and liver problems. So these are the people who are generally not taking or very elderly who are not taking they would be ideal candidate for this procedure. This is also a good procedure for people who take other blood thinners along with these blood thinner when we add a newer one more blood thinner the risk of bleeding would go very high up. It's good for people who who actually has already had a bleed in their brain so they are very scared to take now blood thinner but if they don't take they could be subjecting themselves to one more stroke. It can also be considered as alternative to anticoagulation in select patients where they have reservation towards anticoagulation. It is very important for people to recognize the symptom any chest pain any discomfort especially with sweating whatever age it's important that they seek a medical attention find out that there is a whether there is a heart attack and if it's a heart attack it's very important that we treat it immediately. To do this most hospitals including ours we have 24-7 cath lab facilities most of the time when patients reach our hospital we are able to do angioplasty in 20-25 minutes that's what is needed to prevent damage and recover as much heart muscle as possible.