Left Atrial Appendage Occlusion Similar to Warfarin Anticoagulation

A second manufacturer-sponsored trial shows evolving experience with the Watchman device.

A device to occlude the left atrial appendage (LAA) as an effective alternative to oral anticoagulation in patients with nonvalvular atrial fibrillation (NVAF) has been elusive. Early procedural complications limited the benefit of the Watchman device in the PROTECT-AF trial (NEJM JW General Medicine Aug 27 2009), prompting this second manufacturer-sponsored, multicenter study, the PREVAIL trial (NCT01182441).

The study population included 407 patients with NVAF, CHADS₂ score >2 (or score of 1 with other high-risk characteristics) who were randomized 2:1 to Watchman versus warfarin. Warfarin discontinuation, permitted by successful implantation and documented LAA occlusion, occurred in 92%, 98%, and 99% of Watchman patients at 45 days, 6 mon…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)