JACC. Cardiovascular interventions · 2015
Percutaneous Left Atrial Appendage Closure With the Watchman Device: Long-Term Results Up to 5 Years.
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Wiebe Jens, Franke Jennifer, Lehn Katharina, Hofmann Ilona, Vaskelyte Laura, Bertog Stefan, Sievert Horst
Аннотация
OBJECTIVES: The aim of this study was to evaluate long-term outcomes in patients with atrial fibrillation undergoing percutaneous left atrial appendage (LAA) closure with the Watchman device.
BACKGROUND: Atrial fibrillation is one of the most common arrhythmias and is associated with a high risk for cardioembolic ischemic events, most notably stroke. Percutaneous LAA closure is an alternative to oral anticoagulation, because most thrombi originate from the LAA.
METHODS: All consecutive patients with minimum CHADS2 or CHA2DS2-VASc scores of 1 who underwent LAA closure with the Watchman device between June 2006 and August 2010 were eligible. Follow-up examinations were performed after 45 days to 3 months, 6 months, and 1 year and thereafter annually. Afterward, alternating office visits and telephone follow-up were performed every 6 months.
RESULTS: A total of 102 patients were included. The mean age was 71.6 ± 8.8 years, and 37.3% were women. The mean CHADS2 and CHA2DS2-VASc scores were 2.7 ± 1.3 and 4.3 ± 1.7, respectively. Procedural success was achieved in 96.1% of patients. During a mean follow-up period of 3.0 ± 1.6 years, the annual rates of transient ischemic attack, stroke, intracranial hemorrhage, and death were 0.7%, 0.7%, 1.1%, and 3.5%, respectively.
CONCLUSIONS: LAA closure with the Watchman device is safe and feasible for stroke protection in patients with atrial fibrillation. Low ischemic events rates demonstrate its effectiveness during long-term follow-up.
BACKGROUND: Atrial fibrillation is one of the most common arrhythmias and is associated with a high risk for cardioembolic ischemic events, most notably stroke. Percutaneous LAA closure is an alternative to oral anticoagulation, because most thrombi originate from the LAA.
METHODS: All consecutive patients with minimum CHADS2 or CHA2DS2-VASc scores of 1 who underwent LAA closure with the Watchman device between June 2006 and August 2010 were eligible. Follow-up examinations were performed after 45 days to 3 months, 6 months, and 1 year and thereafter annually. Afterward, alternating office visits and telephone follow-up were performed every 6 months.
RESULTS: A total of 102 patients were included. The mean age was 71.6 ± 8.8 years, and 37.3% were women. The mean CHADS2 and CHA2DS2-VASc scores were 2.7 ± 1.3 and 4.3 ± 1.7, respectively. Procedural success was achieved in 96.1% of patients. During a mean follow-up period of 3.0 ± 1.6 years, the annual rates of transient ischemic attack, stroke, intracranial hemorrhage, and death were 0.7%, 0.7%, 1.1%, and 3.5%, respectively.
CONCLUSIONS: LAA closure with the Watchman device is safe and feasible for stroke protection in patients with atrial fibrillation. Low ischemic events rates demonstrate its effectiveness during long-term follow-up.
Предметные рубрики MeSH
AgedAged, 80 and overAtrial AppendageAtrial FibrillationCardiac CatheterizationEmbolic Protection DevicesFeasibility StudiesFemaleGermanyHumansIntracranial HemorrhagesIschemic Attack, TransientKaplan-Meier EstimateMaleProspective StudiesProsthesis DesignRegistriesRisk FactorsStrokeTime FactorsTreatment Outcome