 DISCUSSION: The incidence of AF increases with the increasing age of the population. In a cohort of 4000 people in the Framingham study, who were followed for more than 30 years, the lifetime risk of the occurrence of AF in a 40 year old man without previous AF was 26 and it was 23 for women. 20. The CHA2DS2-VASc score also rises with increasing age, which means the risk of cardioembolic as well as bleeding events also increase with age; therefore, the number of patients with a need for, but concurrently with a risk of anticoagulant treatment, increases. The safety profile of NOAC has been shown in large randomized studies to be slightly better compared to warfarin, mainly due to the slightly lower incidence of intracranial bleeding. LAA occlusion, which has been shown to be non-inferior to warfarin in a large study 14, can be a possible alternative in patients at high risk for bleeding. However, LAA occlusion has been associated with a significant number of complications, and therefore, the risk of interventional LAA occlusion is acceptable mainly in patients at highest risk for bleeding and stroke.Until now, published and ongoing studies have not focused on this particular group of high-risk patients; for example, an inclusion criterion for the PROTECT trial was only a CHADS2 1 and 34 of all PROTECT patients had a CHADS2 score of 1. 