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Baltimore, MD
Left Atrial Appendage Closure (LAAC) for A-Fib: The Watchman Works!
It’s known that 90%-95% of Atrial Fibrillation-related clots (and strokes) originate from the Left Atrial Appendage (LAA). Intuitively one would expect that devices which close off the LAA (such as the Boston Scientific Watchman and the Abbott Amplatzer Amulet) would lower the risk of stroke. Indeed, that’s what happens according to recent research.
Furthermore, LAA closure devices significantly reduce hemorrhagic stroke (brain bleeds) and overall cardiovascular mortality.
Literature Search of Effectiveness of Left Atrial Appendage Closure (LAAC)
Australian researchers performed a systematic literature search of medical databases to identify all relevant studies assessing outcomes of LACC compared to oral anticoagulant (OAC) therapy.
They screened 284 studies and found 10 which fulfilled their criteria for inclusion. These pooled studies included 12,873 patients who received Left Atrial Appendage Closure (LAAC) and 12,694 who received oral anticoagulant (OAC). There were no significant characteristic differences between the two groups.
Study Findings: Researchers found that Left Atrial Appendage Closure (LAAC) (compared to oral anticoagulant therapy) significantly lowered rates of stroke events, as well as cardiovascular mortality.
Study of Brain Bleed Stroke Among A-Fib Patients
In a study from Boston Mass. General Hospital, researchers looked at A-Fib patients with increased risk of intracranial hemorrhage who received Left Atrial Appendage Closure (LAAC). They found a low risk of recurrent intracranial hemorrhage (ICH) or ischemic stroke among these patients.
Researchers’ conclusion: “LAAC in high ICH risk population should be considered in clinical practice….”
VIDEO: WATCHMAN FLX Device Animation: Implant Technique. Posted by Boston Scientific Cardiology, Feb 1, 2023; 1:11 min. in length.
YouTube video: WATCHMAN FLX Device Animation: Implant Technique
Editor’s Comments
Left Atrial Appendage Closure (LAAC) Devices Work: If anyone tells you that Left Atrial Appendage Closure (LAAC) devices are “unproven”, “don’t work”, or are “too risky”, recent research says the opposite. Closing off the LAA prevents 90%-95% of clots.
In addition, it also lowers hemorrhagic stroke risk (brain bleeds) due to most patients no longer needing to take anticoagulants (blood thinners) which tend to cause brain bleeds. One of the major benefits of having an LAAC, for many people, is no longer having to take blood thinners.
A Left Atrial Appendage Closure installation is one of the safest procedures you can have in a hospital (Yes, I have one, too.)
Use of LAAC was found to be significantly more effective than current drug therapies. (With the New Watchman device, heart tissue soon grows over the device so that no parts of the Watchman are visible or protrude into the heart.)
Left Atrial Appendage Closure Improve Heart Health: Furthermore, research shows that LAAC devices significantly lower cardiovascular mortality. You’re less likely to get ill and die from heart problems when you have a LAAC device installed.
Putting in a LAAC device can be done by experienced Electrophysiologists (EPs) in 20 minutes and often is now being done along with an A-Fib ablation.
A Left Atrial Appendage Closure installation is one of the safest procedures you can have in a hospital (Though any time you go for a hospital procedure there is, of course. some risk.)
UPDATE: The latest version of the Watchman is the Boston Scientific WATCHMAN FLXTM Pro featuring HEMOCOAT™ Technology with three first-ever features: New HEMOCOAT Technology designed to improve the healing process, radiopaque markers for precise device placement, and a new 40mm size for larger appendages. Read more about it here.
