August 1, 2013EuroIntervention
New technical and anticoagulation aspects for left atrial appendage closure using the WATCHMAN® device in patients not taking warfarin
Key result
Left atrial appendage closure using an oversized WATCHMAN device and 45-day DAPT resulted in a 3.3% rate of pericardial effusions, 5% rate of device thrombi, and no device embolizations.
Why the study?
Does WATCHMAN device implantation with larger sizing and post-procedural DAPT improve safety in patients with contraindications to warfarin?
Population
n=59 consecutive patients treated with the WATCHMAN device, including those with contraindications to warfarin
Design
Cohort
Follow-up
6 months
Authors
Discussion
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Implication
May support oversized WATCHMAN with short DAPT in warfarin-contraindicated patients; hypothesis-generating and requires randomized trials before practice change.
Study Design
Type
Observational (n=59)
Structured PICO
Does WATCHMAN device implantation with larger sizing and post-procedural DAPT improve safety in patients with contraindications to warfarin?
P
Population
59 consecutive patients with contraindications to warfarin undergoing left atrial appendage closure with the WATCHMAN device, followed for 6 months.
E
Exposure
WATCHMAN device implantation using a device size 15-30% greater than the LAA diameter, followed by dual antiplatelet therapy (DAPT) for the first 45 days
O
Outcome
Periprocedural safety (pericardial effusions, thrombi at the device, device embolisation, leakage)safety
In patients with contraindications to warfarin, WATCHMAN implantation using larger device sizing and 45-day DAPT appears safe and minimizes leakage.
Cite This Study
Meincke et al. (2013) conducted an observational in Contraindication to warfarin requiring left atrial appendage closure (n=59). WATCHMAN device (oversized 15-30%) and dual antiplatelet therapy was evaluated on Periprocedural safety (pericardial effusions, thrombi, and device embolizations). Left atrial appendage closure using an oversized WATCHMAN device and 45-day DAPT resulted in a 3.3% rate of pericardial effusions, 5% rate of device thrombi, and no device embolizations.