Key result
Left atrial appendage closure using the WATCHMAN device achieved a significant reduction in ischemic stroke rate and a low device-related thrombus incidence.
Why the study?
Access to left atrial appendage closure (LAAC) in Canada is limited by funding restrictions, motivating an assessment of Canadian clinical practice on patient selection, postprocedural antithrombotic therapy, and safety and/or efficacy with WATCHMAN device implantation.
Does left atrial appendage closure with the WATCHMAN device reduce ischemic stroke rates compared to expected rates in Canadian patients with contraindications to oral anticoagulation?
Observational
Yes
Does left atrial appendage closure with the WATCHMAN device reduce ischemic stroke rates compared to expected rates in Canadian patients with contraindications to oral anticoagulation?
In a Canadian registry, LAAC with the WATCHMAN device was associated with a lower-than-expected ischemic stroke rate and low device-related thrombus incidence in patients with contraindications to oral anticoagulation.
Answers are grounded in this paper and cite their sources.
Low stroke rates in high-risk Canadian LAAC patients support safety; hypothesis-generating and should not yet change practice.
Background: Access to left atrial appendage closure (LAAC) in Canada is limited, due to funding restrictions. This work aimed to assess Canadian clinical practice on patient selection, postprocedural antithrombotic therapy, and safety and/or efficacy with WATCHMAN device implantation. Device-related thrombus was detected in 1.8%. Conclusions: The majority of Canadian patients who underwent LAAC had oral anticoagulation contraindication due to prior bleeding, and most were safely treated with antiplatelet therapy post-LAAC, with a low device-related thrombus incidence. Long-term follow-up demonstrated that LAAC achieved a significant reduction in ischemic stroke rate.
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Saw et al. (2023) conducted an observational in Oral anticoagulation contraindication. Left atrial appendage closure (WATCHMAN device) vs. Expected rate based on risk score was evaluated on Ischemic stroke. Left atrial appendage closure using the WATCHMAN device achieved a significant reduction in ischemic stroke rate and a low device-related thrombus incidence.
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