The purpose of this research study is to compare the safety and effectiveness of the Amulet device compared to non-vitamin K antagonist oral anticoagulants (NOACs) for ischemic stroke risk reduction. NOACs are a class or type of drugs taken daily, which thin the blood to reduce blood clots and the risk of an ischemic stroke. An ischemic stroke occurs when a small clot prevents blood and oxygen from reaching part of the brain. While NOACs are effective in preventing blood clots and ischemic stroke, thinning of the blood can increase the risk for bleeding events.