This systematic review is the second update of the review compiled in 2011 and evaluates the efficacy and safety of the percutaneous left atrial appendage closure compared to oral anticoagulation (OAC) with vitamin K antagonists for stroke prevention in patients with atrial fibrillation. The currently available evidence is not sufficient to prove that the percutaneous closure of the left atrial appendage is as effective and as safe as OAC. The intervention could be an appropriate alternative for patients who are not eligible for OAC with vitamin-K antagonists. However, there are currently no studies available that have assessed the efficacy within this population. At present, the inclusion of left atrial appendage closure into the Austrian hospital benefit catalogue is not recommended.