Abstract：
BACKGROUND:Despite results of the PROTECT AF trial, many patients undergoing left atrial appendage closure (LAAC) have unconditional contraindications to warfarin. AIM:We sought to investigate whether double antiplatelet therapy (DAPT) is safe in patients after LAAC. METHODS:Forty-four consecutive patients (22 males, mean age 74 ± 7.8 years) with non-valvular atrial fibrillation (NVAF) underwent LAAC procedure using a Watchman device followed by DAPT (75 mg/d aspirin and 75 mg/d clopidogrel). After the procedure and during 98 days' follow-up including transoesophageal echocardiography, peri-procedural complications and clinical outcomes were investigated. RESULTS:Mean CHA2DS2-VASc score was 4.9 ± 1.5 and mean HAS-BLED score was 3.6 ± 0.8. The main LAAC indication was contraindication to anticoagulation reflected by HAS-BLED score ≥ 3 observed in 95.5% cases (among them history of bleeding in 38 patients, 90.5%). 36.4% of patients have history of stroke or transient ischaemic attack. The procedure was successful in 97.7%. Peri-procedural complications were tamponade (2.3%) and one death (2.3%) unrelated to the procedure with no bleeding or vascular complications. During follow-up neither stroke nor bleeding were observed, whereas two device related thrombi and two unrelated deaths occurred. CONCLUSIONS:LAAC followed by DAPT seems to be a safe and efficient alternative for stroke prevention in patients with NVAF who have contraindications to anticoagulation therapy. This strategy may provide a significant reduction of events such as stroke and bleeding versus the score-predicted rate.
journal_name
Kardiol Poljournal_title
Kardiologia polskaauthors
Maksym J,Mazurek T,Kochman J,Grygier M,Kapłon-Cieślicka A,Marchel M,Lodziński P,Piątkowski R,Wilimski R,Czub P,Fojt A,Karolczak N,Hendzel P,Opolski Gdoi
10.5603/KP.a2017.0245subject
Has Abstractpub_date
2018-01-01 00:00:00pages
459-463issue
2eissn
0022-9032issn
1897-4279pii
VM/OJS/KP/11549journal_volume
76pub_type
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