We recommend that closure (excision or obliteration) of the left atrial appendage be undertaken as part of the surgical ablation of AF associated with mitral valve surgery. (Recommendation Strong, Quality Low)<br /><br />We suggest that closure of the left atrial appendage be undertaken as part of the surgical ablation of persistent AF in patients undergoing aortic valve surgery or coronary artery bypass surgery if this does not increase the risk of the surgery. (Recommendation Conditional, Quality Low)<b>Values and preferences: </b>These recommendations place a high value on stroke reduction and a lower value on any concomitant loss of atrial transport with left atrial appendage closure.