What question did this study set out to answer?

This research aims to evaluate the safety and efficacy of early anticoagulation regimens following WATCHMAN left atrial appendage closure.

September 1, 2017EuroIntervention

Safety and efficacy of early anticoagulation drug regimens after WATCHMAN left atrial appendage closure: three-month data from the EWOLUTION prospective, multicentre, monitored international WATCHMAN LAA closure registry

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Why the study?

Does DAPT or NOAC therapy improve safety (device thrombus, stroke, or bleeding) compared to standard VKA regimen in patients undergoing WATCHMAN LAA closure?

Key Points

This research aims to evaluate the safety and efficacy of early anticoagulation regimens following WATCHMAN left atrial appendage closure.
Prospective multicenter study involving EWOLUTION registry.
Evaluated patients with contraindications to oral anticoagulation.
Monitored device-related thrombus, stroke, and bleeding events.
No significant increase in device thrombus, stroke, or bleeding with DAPT or NOAC compared to VKA.
Numerically lowest event rate observed with NOAC therapy.

Structured PICO

Does DAPT or NOAC therapy improve safety (device thrombus, stroke, or bleeding) compared to standard VKA regimen in patients undergoing WATCHMAN LAA closure?

Population

Patients with a relative or absolute contraindication to oral anticoagulation undergoing left atrial appendage (LAA) closure with the WATCHMAN device

Intervention

Dual antiplatelet therapy (DAPT) or non-vitamin K antagonist oral anticoagulant (NOAC) therapy

Comparator

Standard vitamin K antagonist (VKA) regimen

Outcome

Device thrombus, stroke, or bleedingsafety

DAPT and NOAC therapy appear to be safe and effective alternatives to standard VKA regimens for early anticoagulation following WATCHMAN LAA closure.

Implication

Supports DAPT or NOAC post-WATCHMAN; leaves open randomized confirmation vs VKA before practice change.

Abstract

LAA closure with the WATCHMAN device is feasible in patients with a relative or absolute contraindication to oral anticoagulation. Neither DAPT nor NOAC therapy leads to a significant increase in device thrombus, stroke or bleeding compared to the standard VKA regimen. Numerically, NOAC therapy had the lowest event rate.

Discussion

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Cite This Study

Bergmann et al. (2017) studied this question.

synapsesocial.com/papers/69d79e19d366d3be3248f387 https://doi.org/10.4244/eij-d-17-00042

Topics

Left atrial appendage closure

Atrial fibrillation

Persistent AF management

Anticoagulation in AF

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Implication

Supports DAPT or NOAC post-WATCHMAN; leaves open randomized confirmation vs VKA before practice change.

Safety and efficacy of early anticoagulation drug regimens after WATCHMAN left atrial appendage closure: three-month data from the EWOLUTION prospective, multicentre, monitored international WATCHMAN LAA closure registry

Key Points

Structured PICO

Implication

Abstract

Discussion

Cite This Study

Topics

Safety and efficacy of early anticoagulation drug regimens after WATCHMAN left atrial appendage closure: three-month data from the EWOLUTION prospective, multicentre, monitored international WATCHMAN LAA closure registry

Key Points

Structured PICO

Implication

Abstract

Discussion

Cite This Study

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