Efficacy and safety of percutaneous left atrial appendage closure to prevent thromboembolic events in atrial fibrillation patients with high stroke and bleeding risk

Clinical Research in Cardiology : Official Journal of the German Cardiac Society
Julia SeegerJochen Wöhrle

Abstract

The randomized PROTECT AF trial demonstrated non-inferiority of left atrial appendage (LAA) closure to oral anticoagulation with warfarin. Current guidelines give a class IIb recommendation for LAA closure. We evaluated the efficacy and safety of LAA closure in a consecutive series of non-valvular atrial fibrillation patients with contraindications to long-term oral anticoagulation or at high bleeding risk. 101 consecutive non-valvular atrial fibrillation patients (age 74.7 ± 7.5 years) at high risk for stroke (CHA2DS2-VASc Score 4.4 ± 1.6) and high bleeding risk (HAS-BLED Score 4.2 ± 1.3) received LAA closure with either the Watchman closure device (n = 38) or the Amplatzer cardiac plug (n = 63). Dual antiplatelet therapy with aspirin and clopidogrel was recommended for 3-6 months after device implantation, followed by long-term antiplatelet therapy with aspirin. No anticoagulation was given after device implantation. Mean follow-up was 400 days. One patient (1 %) experienced a transient ischemic attack, and two patients (2 %) suffered from ischemic stroke. While on recommended antiplatelet therapy, bleeding occurred in 12/101 patients (12 %). Bleeding was significantly reduced with 3 compared with 6 months dual antiplatelet t...Continue Reading

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Citations

Oct 31, 2015·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Tobias ZeusAmin Polzin
Apr 3, 2016·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Manuel ViehmannMarcus Sandri
Nov 28, 2015·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Nico ReinschPhilipp Kahlert
Jun 9, 2016·Stroke; a Journal of Cerebral Circulation·Thomas B Stoker, Nicholas R Evans
Mar 19, 2019·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Radoslaw LitwinowiczKrzysztof Bartus
Oct 10, 2019·Journal of Cardiovascular Electrophysiology·Valay ParikhDhanunjaya Lakkireddy
Jul 7, 2019·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Alexander SedaghatSteffen Gloekler
May 26, 2018·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Dan LiuPeter Nordbeck
Dec 12, 2018·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Alexander SedaghatGeorg Nickenig
Dec 1, 2020·The Journal of International Medical Research·Shu-Yue LiHang Xu

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