The Watchman™ left atrial appendage closure for stroke prevention in non-valvular atrial fibrillation patients: feasibility, safety and efficacy

Abstract

Objective To investigate the feasibility, safety and efficacy of Watchman™ left atrial appendage(LAA) closure in Chinese non-valvular atrial fibrillation(AF) patients. AF is associated with significant increased stroke risks for AF patients, mainly due to cardiac embolism from LAA.Percutaneous LAA closure procedure has been developped and proved to be a novel powerful treatment for preventing stroke in AF patients.However, the data of LAA closure in Chinese people are very few up to now. Methods From May 2014 to June 2016, non-valvular AF patients with high stroke risks and unsuitability to long-term anticoagulation therapy were selected for LAA closure procedure.Data of all the patients were recorded and analyzed. Results LAA closure procedures were performed on 164 AF patients and 163 succeeded (99.4%). The implanted devices were all Watchman™.The mean CHA2DS2-VASc score was 2.82±1.32, and the mean HASBLED score was 1.58±0.75.No death occurred in the periopertative period of LAA closure procedure.Safety events occurred in 4 patients (2.45%), 2 cerebral embolisms, 1 pericardial temponade requiring surgical operation and 1 extensive dermal ecchymosis.No major residual flow (>5 mm) was detected and 3 patients(1.88%) had thrombus apposition revealed with transesophageal echocardiography(TEE) after 45 days of the LAA closure procedure.During the follow-up, no death, device fall off or major bleeding events occurred. Conclusion Through our initial experiences, Watchman™ percutaneous LAA closure was a feasible, safe procedure which is an effective one for preventing stroke in Chinese non-valvular AF patients. Key words: Left atrial appendage closure; Atrial fibrillation; Throboembolism; Interventional cardi-ology; Implantation