Primary and Secondary Stroke Prevention Using Left Atrial Appendage Closure with Watchman Devices in Atrial Fibrillation Patients
Background Atrial fibrillation (AF) is associated with increased stroke risk resulting from cardiac embolism of the left atrial appendage (LAA). Stroke tends to recur in NVAF patients. Yet safety and feasibility of secondary stroke preventions with LAA closure (LAAC) have not been assessed in detail...
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Published in | Pacing and clinical electrophysiology Vol. 40; no. 6; pp. 607 - 614 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
Published |
Hoboken
Wiley Subscription Services, Inc
01.06.2017
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Subjects | |
Online Access | Get full text |
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Summary: | Background
Atrial fibrillation (AF) is associated with increased stroke risk resulting from cardiac embolism of the left atrial appendage (LAA). Stroke tends to recur in NVAF patients. Yet safety and feasibility of secondary stroke preventions with LAA closure (LAAC) have not been assessed in detail. This retrospective study was designed to compare the feasibility and safety of LAAC in primary and secondary stroke preventions, in a real‐world setting of Chinese patients.
Methods
From 2014 to 2015, non‐valvular AF patients with CHA2DS2‐VASc ≥1 were selected for percutaneous LAAC operations. Outcome observations of primary and secondary stroke preventions with Watchman devices were analyzed and compared.
Results
Overall, 122 patients were included. LAAC with Watchman devices were attempted in 115 patients, of whom 68 were for primary stroke prevention and 47 were for secondary prevention. Both the CHA2DS2‐VASc score and the HASBLED score were significantly higher in the secondary prevention group (4.09 ± 1.06 vs. 1.93 ± 1.09 for CHA2DS2‐VASc and 1.83 ± 1.03 vs. 1.26 ± 0.87 for HASBLED, P < 0.01). In both groups LAAC were achieved with high successful rate (98.53% in the primary prevention group and 100% in the secondary prevention group, P > 0.05) and low complication rates. The stroke rates were at a low level in both groups (1.47% in primary prevention group vs. 2.13% in secondary prevention group, P > 0.05).
Conclusions
In our initial single‐center experience, percutaneous LAA closure was a feasible and safe procedure for both primary and secondary stroke preventions in Chinese patients with nonvalvular AF. |
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Bibliography: | Funding: Chen Yanhong was supported by an innovation fund from Wuhan Asia Heart Hospital. Zhang Yonghua was supported by a grant from Science and Technology Bureau of Wuhan, China (No. 2015060101010062). Conflict of interest: None declared. Patient consent obtained. Data sharing statement: No additional data are available. Provenance and peer review: Not commissioned; externally peer reviewed. Ethics approval: The study protocol was approved by the Human Research Ethics Committee of the Wuhan Asia Heart Hospital, Wuhan, China. Authors Yanhong Chen and Yonghua Zhang contributed equally to the preparation of this manuscript. |
ISSN: | 0147-8389 1540-8159 |
DOI: | 10.1111/pace.13020 |