Percutaneous left atrial appendage closure with the Watchman device: a systematic review
Atrial fibrillation (AF) is the most commonly observed arrhythmia in the world and its prevalence increases with age. The main and most severe complication of AF is ischemic stroke. Oral anticoagulation (OAC) therapy is the standard of care for stroke prevention in the high risk population. Initiati...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Termedia Publishing House
2024-03-01
|
| Series: | Advances in Interventional Cardiology |
| Subjects: | |
| Online Access: | https://www.termedia.pl/Percutaneous-left-atrial-appendage-closure-with-the-r-nWatchman-device-a-systematic-review,35,52665,1,1.html |
| _version_ | 1797214544232185856 |
|---|---|
| author | Jakub Maksym Marcin Grabowski Tomasz Mazurek |
| author_facet | Jakub Maksym Marcin Grabowski Tomasz Mazurek |
| author_sort | Jakub Maksym |
| collection | DOAJ |
| description | Atrial fibrillation (AF) is the most commonly observed arrhythmia in the world and its prevalence increases with age. The main and most severe complication of AF is ischemic stroke. Oral anticoagulation (OAC) therapy is the standard of care for stroke prevention in the high risk population. Initiation of this treatment is associated with a substantial risk of bleeding complications. Moreover, there is a group of patients who cannot tolerate OAC. In patients with AF the left atrial appendage (LAA) is the main source of thrombus formation. Percutaneous left atrial appendage closure (LAAC) has become an important non-pharmacological intervention for stroke prevention in patients with non-valvular AF. The procedure aims to reduce the risk of thromboembolism without increasing the risk of bleeding. Over the last few years, the safety and long-term efficacy of the procedure in specific populations have increased and more patients are being treated. The Watchman device is the most studied device in this field. Randomized controlled trials demonstrated non-inferiority of percutaneous left atrial appendage closure using the WATCHMAN 2.5 device to OAC (Boston Scientific, Marlborough, MA, USA). The new generation device, WATCHMAN FLX, was introduced and its use was associated with fewer safety events and a higher success rate of effective appendage closure. Nevertheless, several unsolved problems remain, including device-related thrombosis, the post-LAAC antithrombotic regimen, and peri-device leakage. This review will focus on LAAC with the Watchman device for stroke prevention in AF patients. Current status, available literature, clinical safety and efficacy will be summarized. |
| first_indexed | 2024-04-24T11:15:51Z |
| format | Article |
| id | doaj.art-3756324453f34134a1282b48680a8707 |
| institution | Directory Open Access Journal |
| issn | 1734-9338 1897-4295 |
| language | English |
| last_indexed | 2024-04-24T11:15:51Z |
| publishDate | 2024-03-01 |
| publisher | Termedia Publishing House |
| record_format | Article |
| series | Advances in Interventional Cardiology |
| spelling | doaj.art-3756324453f34134a1282b48680a87072024-04-11T08:17:30ZengTermedia Publishing HouseAdvances in Interventional Cardiology1734-93381897-42952024-03-01201182910.5114/aic.2024.13640652665Percutaneous left atrial appendage closure with the Watchman device: a systematic reviewJakub MaksymMarcin GrabowskiTomasz MazurekAtrial fibrillation (AF) is the most commonly observed arrhythmia in the world and its prevalence increases with age. The main and most severe complication of AF is ischemic stroke. Oral anticoagulation (OAC) therapy is the standard of care for stroke prevention in the high risk population. Initiation of this treatment is associated with a substantial risk of bleeding complications. Moreover, there is a group of patients who cannot tolerate OAC. In patients with AF the left atrial appendage (LAA) is the main source of thrombus formation. Percutaneous left atrial appendage closure (LAAC) has become an important non-pharmacological intervention for stroke prevention in patients with non-valvular AF. The procedure aims to reduce the risk of thromboembolism without increasing the risk of bleeding. Over the last few years, the safety and long-term efficacy of the procedure in specific populations have increased and more patients are being treated. The Watchman device is the most studied device in this field. Randomized controlled trials demonstrated non-inferiority of percutaneous left atrial appendage closure using the WATCHMAN 2.5 device to OAC (Boston Scientific, Marlborough, MA, USA). The new generation device, WATCHMAN FLX, was introduced and its use was associated with fewer safety events and a higher success rate of effective appendage closure. Nevertheless, several unsolved problems remain, including device-related thrombosis, the post-LAAC antithrombotic regimen, and peri-device leakage. This review will focus on LAAC with the Watchman device for stroke prevention in AF patients. Current status, available literature, clinical safety and efficacy will be summarized.https://www.termedia.pl/Percutaneous-left-atrial-appendage-closure-with-the-r-nWatchman-device-a-systematic-review,35,52665,1,1.htmlatrial fibrillation left atrial appendage closure device-related thrombus peri-device leak |
| spellingShingle | Jakub Maksym Marcin Grabowski Tomasz Mazurek Percutaneous left atrial appendage closure with the Watchman device: a systematic review Advances in Interventional Cardiology atrial fibrillation left atrial appendage closure device-related thrombus peri-device leak |
| title | Percutaneous left atrial appendage closure with the
Watchman device: a systematic review |
| title_full | Percutaneous left atrial appendage closure with the
Watchman device: a systematic review |
| title_fullStr | Percutaneous left atrial appendage closure with the
Watchman device: a systematic review |
| title_full_unstemmed | Percutaneous left atrial appendage closure with the
Watchman device: a systematic review |
| title_short | Percutaneous left atrial appendage closure with the
Watchman device: a systematic review |
| title_sort | percutaneous left atrial appendage closure with the watchman device a systematic review |
| topic | atrial fibrillation left atrial appendage closure device-related thrombus peri-device leak |
| url | https://www.termedia.pl/Percutaneous-left-atrial-appendage-closure-with-the-r-nWatchman-device-a-systematic-review,35,52665,1,1.html |
| work_keys_str_mv | AT jakubmaksym percutaneousleftatrialappendageclosurewiththewatchmandeviceasystematicreview AT marcingrabowski percutaneousleftatrialappendageclosurewiththewatchmandeviceasystematicreview AT tomaszmazurek percutaneousleftatrialappendageclosurewiththewatchmandeviceasystematicreview |