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Revista Colombiana de Cardiología

Print version ISSN 0120-5633

Abstract

FERNANDEZ, Andrés et al. Short-term safety and efficacy of left atrial appendage closure using WATCHMAN ® device for non-valvular atrial fibrillation in patients with a high risk of bleeding. Rev. Colomb. Cardiol. [online]. 2017, vol.24, n.4, pp.369-375.  Epub Feb 03, 2017. ISSN 0120-5633.  http://dx.doi.org/10.1016/j.rccar.2016.10.048.

Motivation:

To assess the safety and efficacy of percutaneous left atrial appendage closure in patients with non-valvular atrial fibrillation with a high risk of bleeding or a contraindication to oral anticoagulation drugs.

Methods:

Prospective non-randomised study of a cohort of patients with atrial fibrillation who had a contraindication to or difficulties with oral anticoagulation, CHA2DS2-VASc ≥ 2 and HASBLED ≥ 2 scores, and who were eligible for dual antiaggregation therapy with aspirin and clopidogrel.

Results:

53 patients with an average age of 72.24 ± 9.22 years were included, out of whom 54.72% were men, 20.75% had paroxysmal, 15.1% persistent and 64.15% permanent atrial fibrillation, respectively. Besides, 18.9% suffered from heart failure, 22.64% from coronary disease, 92.45% from arterial hypertension, 41.51% were over 75 years old, 18.9% were diabetic and 37.7% had a history of cerebrovascular disease. Average CHADS= y CHA=DS2-VASc scores were of 2.73 ± 1.34 and 4.24 ± 1.54 respectively. Procedure was successful in 98% of the cases (52/53). It was not possible to implant the device in only one case due to anatomical reasons. There were no severe adverse events related to the insertion; during the procedure an episode of mild pericardial effusion that did not require drainage was registered. DUring the 45-day follow up period, 2 patients (3.77%) developed a cerebrovascular disease, and there was one noncardiac death (1.89%).

Conclusions:

The percutaneous left atrial appendage closure with device is a safe and efficient procedure in high-risk patients with non-valvular atrial fibrillation and contraindications to or difficulties for oral anticoagulation therapy.

Keywords : Paroxysmal atrial fibrillation; Cerebrovascular disease; Percutaneous closure.

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