Does left atrial appendage closure (LAAC) with Watchman prevent stroke and reduce bleeding or mortality compared to warfarin in patients with nonvalvular atrial fibrillation?
At 5 years of follow-up, LAAC with the Watchman device offers comparable stroke prevention to warfarin in nonvalvular AF, while reducing major bleeding, hemorrhagic stroke, and mortality.
These 5-year outcomes of the PREVAIL trial, combined with the 5-year outcomes of the PROTECT AF trial, demonstrate that LAAC with Watchman provides stroke prevention in nonvalvular atrial fibrillation comparable to warfarin, with additional reductions in major bleeding, particularly hemorrhagic stroke, and mortality. (WATCHMAN Left Atrial Appendage System for Embolic Protection in Patients With Atrial Fibrillation; NCT00129545; and Evaluation of the WATCHMAN LAA Closure Device in Patients With Atrial Fibrillation Versus Long Term Warfarin Therapy; NCT01182441).
Reddy et al. (Sat,) studied this question.