Objective. To substantiate the indications for isolated thoracoscopic left atrial appendage exclusion in patients with atrial fibrillation. Material and methods. The study is based on the treatment of 94 patients with non-paroxysmal atrial fibrillation. Nine patients (9.6%) were denied thoracoscopic radiofrequency ablation of the left atrial appendage after examination. Refusal was determined by collegial recognition of the futility of restoring sinus rhythm in other ways or contraindications for thoracoscopic radiofrequency fragmentation of the left atrium (obesity, manifestation of atrial fibrillation during antitumor therapy, alcoholism, hypertrophic cardiomyopathy, encephalopathy and absence of compliance with the treatment). Seven patients underwent isolated thoracoscopic resection of the left atrial appendage, two patients refused surgery. Results. Two patients who refused surgery died from embolic complications (ischemic stroke) in 3 and 7 months after consultation. Complications, including mortality, bleeding, phrenic nerve paresis, acute cerebrovascular accident, pleuritis, pneumothorax within 30 days after surgery were absent. There were no thromboembolic complications in 7 operated patients within postoperative follow-up period (1—12 months). Conclusion. Isolated thoracoscopic left atrial appendage exclusion is indicated in patients with atrial fibrillation, risk of thromboembolic complications and the absence of other cardiac diseases in combination with collegially recognized futility of restoring sinus rhythm in other ways.