Dr. Lucas Gambill reviews the formal shared decision-making interaction implemented by Sentara, using the evidence-based decision tool for patients prior to having left atrial appendage occlusion (LAAO). We're using the shared decision making pathway for variety of procedures including left atrial appendage inclusion. When we see patients in clinic, who we think would benefit from this procedure, we typically refer them to the electrophysiology team for further evaluation and management. Prior to this, we have to make sure that the appropriate patients are getting referred for the appropriate procedures. So we work in collaboration with each patient explaining the risks benefits and alternatives to proceeding with this procedure. After careful collaboration with the patient, in which we utilize evidence based medicine and clinical risk calculators, the collective decision is then made with the patient's needs and preferences in mind. With the ultimate goal of improving their quality of life. We pride ourselves on taking extra time to answer all questions many times with additional family members present so that the patient feels comfortable with their treatment plan in doing so, we strive to achieve the best clinical outcomes for our patients.