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The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
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Left Atrial Appendage Closure with the Watchman FLX System in a Patient with Hypertrophic Cardiomyopathy on Dialysis

Takashi Funaki1, Mike Saji1,2, Mai Terada1

  • 1Department of Cardiology, Sakakibara Heart Institute, Japan.

Internal Medicine (Tokyo, Japan)
|June 21, 2023
PubMed

Insights

Hypertrophic cardiomyopathy patients with atrial fibrillation usually get anticoagulation. However, left atrial appendage closure using the Watchman FLX system may be a safe alternative for those requiring hemodialysis.

Area of Science:

  • Cardiology
  • Interventional Cardiology

Background:

  • Hypertrophic cardiomyopathy (HCM) frequently co-occurs with atrial fibrillation, a condition typically managed with anticoagulation.
  • Anticoagulation is contraindicated in patients requiring hemodialysis (HD) due to elevated bleeding risks.

Observation:

  • A case report details a patient with dilated phase HCM and persistent atrial fibrillation who also required hemodialysis.
  • This patient underwent left atrial appendage closure (LAAC) using the Watchman FLX system.

Findings:

  • Left atrial appendage closure (LAAC) with the Watchman FLX system was successfully performed.
  • This procedure offers a potential alternative to systemic anticoagulation in this high-risk patient cohort.

Implications:

  • Left atrial appendage closure (LAAC) may provide a viable stroke risk reduction strategy for patients with hypertrophic cardiomyopathy and atrial fibrillation who are on hemodialysis.
  • This case highlights the potential of device-based closure as an alternative to antithrombotic therapy in specific complex patient profiles.

Keywords:
hemodialysishypertrophic cardiomyopathyleft atrial appendage closure

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