Devices and methods for left atrial appendage closure

A method of closing an atrial appendage comprising:

• positioning a distal end of a first guide element in the interior of the atrial appendage;
• advancing a balloon catheter along the first guide element, wherein the balloon catheter comprises a balloon;
• positioning a distal end of a second guide element in a pericardial space externally of the atrial appendage, wherein the first guide element is aligned across the second guide element on opposite sides of the heart;
• advancing a closure assembly of a closure device around an exterior of the atrial appendage along the second guide;
• inflating the balloon within the atrial appendage;
• withdrawing the first guide element from the interior of the atrial appendage;
• closing the atrial appendage with the closure assembly;
• advancing a portion of the first guide element into contact with tissue around an ostium of the closed atrial appendage;
• and
• ablating the contacted tissue with the first guide member.