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Войти в исследования American journal of cardiovascular disease · 2026
Outcomes of Watchman device implantation in atrial fibrillation patients contraindicated for long-term anticoagulation: a single-center experience.
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Ghumman Ghulam Mujtaba, Kalsoom Sidra, Salman Fnu, Noman Anas, Kanaan Tarif, Meenakshisundaram Chandramohan, Alo Mohammed, Zafrullah Fnu, Alo Sinan, Ali Syed Sohail, Taleb Mohammed
Аннотация
BACKGROUND: Left atrial appendage occlusion (LAAO) using the Watchman device is an established strategy for stroke prevention in atrial fibrillation (AF) patients at high thromboembolic risk who cannot tolerate long-term oral anticoagulation (OAC).
OBJECTIVES: To evaluate short-term clinical and echocardiographic outcomes of Watchman implantation in AF patients with contraindications to long-term OAC.
METHODS: We conducted a retrospective single-center study of AF patients who underwent Watchman implantation between September 01, 2023, and March 01, 2025. Baseline demographics, comorbidities, procedural characteristics, complications, antithrombotic strategies, and 45-day outcomes were analyzed. Outcomes were compared between patients with and without follow-up TEE. Data were analyzed using SAS v9.4. All tests were two-tailed, and a p-value <0.05 was considered statistically significant.
RESULTS: Among 10,078 AF patients, 120 underwent Watchman implantation; 105 met the inclusion criteria. The mean age was 75.8±7.8 years, and 46.7% were female. Implant success was 100%. Pericardial effusion occurred in 11 patients (10.5%, 95% CI 5.4-18.0%), including tamponade requiring pericardiocentesis in 2 patients (1.9%). Vascular access complications occurred in 3 patients (2.9%, 95% CI 0.6-8.1%). No device embolizations, device-related thrombi, or periprocedural strokes were observed. Most patients (88.5%) were discharged on dual antiplatelet therapy, while 3.8% received single antiplatelet therapy. At 45 days, 89 patients (84.8%) completed TEE; device position was stable in all. One patient (1.1%, 95% CI 0.03-6.1%) had a significant peridevice leak (>5 mm), and none had device-related thrombus. Clinical outcomes included one hemorrhagic stroke (1.1%) and eight rehospitalizations (7.6%, 95% CI 3.4-14.5%), unrelated to the device. No ischemic strokes were observed.
CONCLUSION: Watchman implantation achieved a 100% success rate with low complication rates and favorable short-term clinical and echocardiographic outcomes in AF patients contraindicated for long-term anticoagulation.
OBJECTIVES: To evaluate short-term clinical and echocardiographic outcomes of Watchman implantation in AF patients with contraindications to long-term OAC.
METHODS: We conducted a retrospective single-center study of AF patients who underwent Watchman implantation between September 01, 2023, and March 01, 2025. Baseline demographics, comorbidities, procedural characteristics, complications, antithrombotic strategies, and 45-day outcomes were analyzed. Outcomes were compared between patients with and without follow-up TEE. Data were analyzed using SAS v9.4. All tests were two-tailed, and a p-value <0.05 was considered statistically significant.
RESULTS: Among 10,078 AF patients, 120 underwent Watchman implantation; 105 met the inclusion criteria. The mean age was 75.8±7.8 years, and 46.7% were female. Implant success was 100%. Pericardial effusion occurred in 11 patients (10.5%, 95% CI 5.4-18.0%), including tamponade requiring pericardiocentesis in 2 patients (1.9%). Vascular access complications occurred in 3 patients (2.9%, 95% CI 0.6-8.1%). No device embolizations, device-related thrombi, or periprocedural strokes were observed. Most patients (88.5%) were discharged on dual antiplatelet therapy, while 3.8% received single antiplatelet therapy. At 45 days, 89 patients (84.8%) completed TEE; device position was stable in all. One patient (1.1%, 95% CI 0.03-6.1%) had a significant peridevice leak (>5 mm), and none had device-related thrombus. Clinical outcomes included one hemorrhagic stroke (1.1%) and eight rehospitalizations (7.6%, 95% CI 3.4-14.5%), unrelated to the device. No ischemic strokes were observed.
CONCLUSION: Watchman implantation achieved a 100% success rate with low complication rates and favorable short-term clinical and echocardiographic outcomes in AF patients contraindicated for long-term anticoagulation.