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Left Atrial Appendage Occlusion for The Unmet Clinical Needs of Stroke Prevention in Nonvalvular Atrial Fibrillation  David R. Holmes, MD, Mohamad Alkhouli,

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Presentation on theme: "Left Atrial Appendage Occlusion for The Unmet Clinical Needs of Stroke Prevention in Nonvalvular Atrial Fibrillation  David R. Holmes, MD, Mohamad Alkhouli,"— Presentation transcript:

1 Left Atrial Appendage Occlusion for The Unmet Clinical Needs of Stroke Prevention in Nonvalvular Atrial Fibrillation  David R. Holmes, MD, Mohamad Alkhouli, MD, Vivek Reddy, MD  Mayo Clinic Proceedings  Volume 94, Issue 5, Pages (May 2019) DOI: /j.mayocp Copyright © 2019 Mayo Foundation for Medical Education and Research Terms and Conditions

2 Figure 1 Adherence to antithrombotic therapy for stroke prevention in patients with atrial fibrillation in clinical practice. NOAC = novel oral anticoagulation. Mayo Clinic Proceedings  , DOI: ( /j.mayocp ) Copyright © 2019 Mayo Foundation for Medical Education and Research Terms and Conditions

3 Figure 2 Source of cardiac emboli and confirmation of the role of left atrial appendage exclusion for stroke prevention in patients with atrial fibrillation. A, Origin of cardiac emboli in patients with atrial fibrillation (Blackshear et al3). B, Confirmation of the role of left atrial appendage exclusion for stroke prevention in patients with atrial fibrillation (Reddy et al12). CVA = cerebrovascular accident; LAA = left atrial appendage. Mayo Clinic Proceedings  , DOI: ( /j.mayocp ) Copyright © 2019 Mayo Foundation for Medical Education and Research Terms and Conditions

4 Figure 3 Patient-level meta-analysis of the randomized clinical trials comparing the Watchman device with warfarin for stroke prevention in patients with atrial fibrillation. CV = cardiovascular; HR = hazard ratio; MRS = Modified Rankin Score; SE = systemic embolization. Mayo Clinic Proceedings  , DOI: ( /j.mayocp ) Copyright © 2019 Mayo Foundation for Medical Education and Research Terms and Conditions

5 Figure 4 Procedural success rates in patients undergoing percutaneous left atrial appendage occlusion with the Watchman device in randomized clinical trials and prospective registries. ASAP = ASA Plavix Feasibility Study With WATCHMAN Left Atrial Appendage Closure Technology; CAP = Continuous Access Registry; EWOLUTION = Registry on WATCHMAN Outcomes in Real-Life Utilization; FDA = Food and Drug Administration; PAF = PROTECT AF (WATCHMAN Left Atrial Appendage System for Embolic PROTECTion in Patients With Atrial Fibrillation) trial; PREVAIL = Evaluation of the WATCHMAN Left Atrial Appendage (LAA) Closure Device in Patients With Atrial Fibrillation Versus Long Term Warfarin Therapy; WASP = Registry on Watchman Outcomes in Real-Life Utilization. Mayo Clinic Proceedings  , DOI: ( /j.mayocp ) Copyright © 2019 Mayo Foundation for Medical Education and Research Terms and Conditions


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