Related Experiment Video
Updated: Mar 7, 2026
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Non-Pharmacologic Approach to Prevent Embolization in Patients with Atrial Fibrillation in Whom Anticoagulation is
Munish Sharma1, Koroush Khalighi2
1Department of Internal Medicine, Easton Hospital , Easton, PA.
Insights
Left atrial appendage closure (LAAC) using the Watchman device offers an effective alternative to anticoagulation for atrial fibrillation (AF) patients at high bleeding risk. This therapy reduces stroke risk in AF patients unsuitable for blood thinners.
Area of Science:
- Cardiology
- Medical Devices
- Stroke Prevention
Background:
- Atrial fibrillation (AF) significantly increases ischemic stroke risk.
- Anticoagulation is standard but contraindicated in some patients due to bleeding risk.
Observation:
- Left atrial appendage closure (LAAC) devices provide a non-pharmacologic alternative.
- The US-FDA-approved Watchman device is increasingly adopted in various medical settings.
- This study presents the initial three Watchman device placements at our institution.
Findings:
- Watchman device placement was successfully performed in three patients.
- Indications for LAAC device implantation were evaluated.
- The individual efficacy of the LAAC procedures was reviewed.
Implications:
- LAAC devices, particularly the Watchman device, expand treatment options for AF patients.
- This therapy is crucial for patients with contraindications to anticoagulation.
- Expanding access to LAAC devices in community hospitals improves stroke prevention strategies.
Abstract:
Ischemic stroke is the most common complication of atrial fibrillation (AF). Anticoagulation therapy reduces the risk of systemic embolization in almost all patients with AF irrespective of the type of AF (paroxysmal, persistent or permanent). But, all patients are not suitable candidates for systemic anticoagulation mainly due to the risk of bleeding. Left atrial appendage closure (LAAC) devices have been found to be very effective non-pharmacologic alternative therapy for such patients. There are various types of LAAC devices but United States Food and Drug Administration (US-FDA) have approved only Watchman device. Initially, bigger medical centers in the US had started the insertion of Watchman device but with improving procedural techniques and exciting outcomes, even the community-based hospitals have started to embrace this therapy. We have presented the first three cases of Watchman device placement performed in our hospital and discussed about the indications for placement of LAAC devices. We have also reviewed their efficacy individually.
Related Concept Videos
01:29Venous Thrombosis III: Interprofessional Care
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
01:18Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
01:27Pulmonary Embolism III: Nursing Management
01:20Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...