The most frequently occurring complication in patients with atrial fibrillation is thromboembolism and in particular ischaemic stroke. It is believed that in more than 90% of all cases the thrombus originates from the left atrial appendage. Currently, the gold standard in the therapy of atrial fibrillation is oral anticoagulation (OAC) with vitamin-K antagonists. The percutaneous closure of the left atrial appendage is a non-pharmacological approach aiming at preventing thromboembolic events, such as ischaemic stroke. This systematic review is an update of the review compiled in 2011 and aims to assess the efficacy and safety of percutaneous left atrial appendage closure compared to OAC with vitamin K antagonists for stroke prevention in patients with atrial fibrillation.