Abstract
Objective The goal of this study was to assess the safety and efficacy of left atrial appendage occlusion(LAAO) for stroke prevention in Chinese patients with nonvalvular atrial fibrillation(AF), compared with long-term warfarin therapy. Methods We selected 25 nonvalvular AF patients who received LAAO in the department of cardiovascular medicine of Renmin Hospital of Wuhan University from March 2014 to August 2015(LAAO group). In LAAO group, the dual antiplatelet medication (aspirin plus clopidogrel) was given for at least 3 months, in the third month to change dual antiplatelet medication for single antiplatelet according to the examination result of transesophageal echocardiography(TEE), with the ratio of 1∶1 selected AF patient who receive chronic warfarin therapy as the control group(warfarin group). In warfarin group, standard medication of warfarin was given adjusting the INR in the range between 2.0 and 3.0.After discharge, patients were followed at 1, 3, 6, 12 months.The effectiveness and safety were evaluated. Results ①The operation success rate was 100% for the patients who receive LAAO.During perioperative period, there was one case of thrombosis, and no complications such as bleeding, death and thrombosis on the occluder surface was observed.During 1 year of follow-up, there was no adverse events such cardiac tamponade, device related embolism, or death between two groups.During 1 year of follow-up, 3 cases had the bleeding event in LAAO group, while 10 cases in the warfarin group(P>0.05). After 3 months, there no bleeding event in LAAO group.In the warfarin group, 6 patients had bleeding event (P<0.05). ②Follow-up for one year, there was no thromboembolic events in LAAO group and warfarin group. Conclusion Present study shows LAAO is safe and effective for the prevention of thromboembolism in Chinese patients with AF.It can reduce the incidence of bleeding events after 3 months. Key words: Atrial fibrillation; Left atrial appendage occlusion; Warfarin; Thromboembolism
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