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Experience of left atrial appendage occlusion with the WATCHMAN device in Chinese patients [Anatol J Cardiol]
Anatol J Cardiol. Ahead of Print: AJC-75435 | DOI: 10.14744/AnatolJCardiol.2019.75435  

Experience of left atrial appendage occlusion with the WATCHMAN device in Chinese patients

Zhengqin Zhai1, Min Tang1, Xi Su2, Huimin Chu3, Weijian Huang4, Jie Zeng5, Jianan Wang6, Pihua Fang1, Xiaomeng Yin7, Genshan Ma8, Shuang Zhao1, Shu Zhang1
1Department Of Arrhythmia, State Key Laboratory Of Cardiovascular Disease, National Clinical Research Center Of Cardiovascular Diseases, Fuwai Hospital, National Center For Cardiovascular Diseases, Chinese Academy Of Medical Sciences And Peking Union Medical College, Beijing, China
2Department Of Cardiology, Wuhan Asia Heart Hospital, Wuhan, China
3Department Of Cardiology, Ningbo First Hospital, Ningbo, China
4Department Of Cardiology, The First Affiliated Hospital Of Wenzhou Medical University, Wenzhou, China
5Department Of Cardiology, Sichuan Provincial People’s Hospital, Chengdu, China
6Department Of Cardiology, The Second Affiliated Hospital Of Zhejiang University School Of Medicine, Hangzhou, China
7Department Of Cardiology, The First Affiliated Hospital Of Dalian Medical University, Dalian, China
8Department Of Cardiology, Zhongda Hospital Southeast University, Nanjing, China

Objectives
Little is known about left atrial appendage occlusion (LAAO) with WATCHMAN device in patients with atrial fibrillation in China. This study was aimed to evaluate the acute procedural performance and complication rate of LAAO procedures and patient selection in China.

Methods
A total of 658 consecutive Chinese patients who were referred to receive LAAO procedures with the WATCHMAN device between 2014 and 2017 were retrospectively included in this study and were divided four groups according to the year of procedures (Group 2014, Group 2015, Group 2016, Group 2017). The procedural success, complication rates and characteristics of Chinese patients as well as the trends of patients’ selection and management were analysed.

Results
The average age was 67.7 ± 9.2 years old, the CHA2DS2-VASc score was 3.7 ± 1.6, and the HAS-BLED score was 2.5 ± 1.1. Both the scores of patients in different years show obvious increasing trends (r = 0.126, P = 0.001; r = 0.145. P < 0.001, respectively). Indications for LAAO included increased bleeding risk (45.6%), recent bleeding under oral anticoagulation (OAC) (9.0%) and non-compliance with OAC (51.4%). The implantation was successful in 643 (97.7%) patients, with a procedural complication rate of 0.6%. Approximately 80.1% of the patients received OAC after LAAO.

Conclusions
In China, LAAO with WATCHMAN devices in AF patients can be performed successfully with a low complication rate. Most of the target population had increased bleeding risk or non-compliance for OAC as indications and received OAC for antithrombotic therapy after procedure.

Keywords: stroke, atrial fibrillation, left atrial appendage, WATCHMAN device




Corresponding Author: Shu Zhang, China


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