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Surabhi no is the head of our EP service and these last two talks both he and dr. Lynn are getting a little outside the valve world but into sort of complementary structural interventions and hes going to talk to us about the left atrial appendage occlusion procedures and devices indications and expectations we go so its a little bit of change in in topics but were going to be talking about left atrial appendage occlusion and their role in stroke prevention inator fibrillation indications and expectation this is a a tough set of issues to discuss because the evidence and the dogma is still not not settled and theres still a lot of uncertainties but as a preamble we need to know that inter female agent has important prognostic implications it doubles at least doubles the risk of stroke in certain populations you can multiply the risk of stroke up to 10 times 7 and it thats associated with an increase in mortality and we know that the vast majority of strokes inator fibrillation co