Use of Direct Oral Anticoagulation Therapy Following Implantation of the Watchman Left Atrial Appendage Occlusion Device

Tjoe, Benita; Nguyen, Hoang; Mandava, Sri; Quintos, Jessica; Li, Jing; Yim, Sung Vin; Shafer, Colin D.; Thompson, Caleb D.; Shenoda, Michael; Cogert, G.; Gidney, Brett; Aragon, Joseph

doi:10.1080/24748706.2021.1890286

Cited by 5 publications

(1 citation statement)

References 13 publications

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“…In line with this, Tjoe et al showed, in a retrospective analysis of 213 patients, that use of DOAC with or without aspirin had similar safety and efficacy profile post-WATCHMAN device implantation when compared to warfarin and aspirin use. 63 Furthermore, robust nationwide data on oral anticoagulation following LAAO became recently available from the LAAO Registry of the National Cardiovascular Data Registry that enrolled patients implanted with the WATCHMAN device in the US. 64 This extensive analysis of 31,994 patients who underwent successful LAAO showed that the most significant deviations from implantation protocol were observed in post-discharge antithrombotic medications.…”

Section: Continuous Oral Anticoagulant Regimen Following Left Atrial ...mentioning

confidence: 99%

Treatment of Persistent Left Atrial Appendage Thrombus in Patients with Atrial Fibrillation on Adequate Oral Anticoagulation: Pathways of Care for All-comers and Heart Failure Patients

Katić

Borovac

2023

Card Fail Rev

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In patients with AF, the presence of left atrial/left atrial appendage (LA/LAA) thrombus is related to an increased risk of thromboembolic events. Anticoagulation therapy, either with vitamin K antagonists or novel oral anticoagulants (NOACs) is therefore mandatory in AF with LA/LAA thrombus in order to lower the risk of stroke or other systemic embolic events. Despite the efficacy of these treatments, some patients will have persistent LAA thrombus remaining or may have contraindications to oral anticoagulation. Currently, little is known about the occurrence, risk factors and resolution rate of LA/LAA thrombus in patients who are already under optimal chronic oral anticoagulation, including vitamin K antagonists or NOACs. The common action in clinical practice in this scenario is switching from one to another anticoagulant drug exhibiting a different mechanism of action. Repeated cardiac imaging is then advised within several weeks to visually verify thrombus dissolution. Finally, there is a substantial scarcity of data on the role and optimal use of NOACs after LAA occlusion. The aim of this review is to critically evaluate data and provide up-to-date information on the best antithrombotic strategies in this challenging clinical scenario.

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Section: Continuous Oral Anticoagulant Regimen Following Left Atrial ...mentioning

confidence: 99%

Treatment of Persistent Left Atrial Appendage Thrombus in Patients with Atrial Fibrillation on Adequate Oral Anticoagulation: Pathways of Care for All-comers and Heart Failure Patients

Katić

Borovac

2023

Card Fail Rev

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Warfarin/aspirin

2021

Reactions Weekly

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Warfarin/aspirin Haemorrhagic pericardial effusion: case reportIn a retrospective, single-center study involving 61 patients (evaluable) treated following left atrial appendage occlusion (LAAO) between 2016 and 2019, 1 patient [age and sex not stated] was described, who developed haemorrhagic pericardial effusion during treatment with warfarin/aspirin [routes and dosages not stated].The patient underwent LAAO with the Watchman device, and within 6-12 hours post procedure, started receiving therapy with warfarin/aspirin. Subsequently, a transesophageal echocardiography (TEE) was performed as a follow-up procedure. However, 45 days post implantation, the patient developed haemorrhagic pericardial effusion attributed to therapy with warfarin/aspirin [duration of treatment to reaction onset not stated]. Thereafter, the patient died as a result of respiratory failure and other complications.

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Direct Oral Anticoagulant Versus Warfarin After Left Atrial Appendage Closure With WATCHMAN: Updated Systematic Review and Meta-analysis

Tan

Wong²,

Lee³

et al. 2022

Current Problems in Cardiology

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Use of Direct Oral Anticoagulation Therapy Following Implantation of the Watchman Left Atrial Appendage Occlusion Device

Cited by 5 publications

References 13 publications

Treatment of Persistent Left Atrial Appendage Thrombus in Patients with Atrial Fibrillation on Adequate Oral Anticoagulation: Pathways of Care for All-comers and Heart Failure Patients

Treatment of Persistent Left Atrial Appendage Thrombus in Patients with Atrial Fibrillation on Adequate Oral Anticoagulation: Pathways of Care for All-comers and Heart Failure Patients

Warfarin/aspirin

Direct Oral Anticoagulant Versus Warfarin After Left Atrial Appendage Closure With WATCHMAN: Updated Systematic Review and Meta-analysis

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