Cardiac Devices and Procedures for Occlusion of the Left Atrial Appendage

Aetna covers FDA‑PMA left atrial appendage closure (LAAC) devices for non‑valvular atrial fibrillation only when the device’s FDA‑approved indication is met and the patient has CHADS2 ≥2 or CHA2DS2‑VASc ≥3, a documented shared‑decision interaction with an independent non‑interventional physician using an evidence‑based oral anticoagulation tool, and is able to undergo short‑term DAPT or warfarin for ~45 days plus long‑term aspirin but is judged unable to take long‑term oral anticoagulation (e.g., thromboembolism despite therapeutic anticoagulation). Percutaneous LAA closure with any device other than the Watchman or Amplatzer Amulet, surgical LAA exclusion (clip, excision, ligation, AtriClip, Lariat) as a stand‑alone or for stroke prevention during/open thoracoscopic cardiac procedures, and all other indications are considered experimental/investigational and excluded.

"Suitability for short-term dual antiplatelet therapy or warfain for 45 days and long-term aspirin but deemed unable to take long-term oral anticoagulation for one or more of the following reasons, ..."