Between 2016 and 2018, the ACC National Cardiovascular Data Registry (NCDR) LAAO Registry enrolled 36,681 patients undergoing WATCHMAN implantation.  Mean age was 76 years; mean CHA2DS2-VASc score was 4.8; and mean HAS-BLED score was 3.0, with 70% of patients having a history of bleeding.  At one year follow-up, the rate of ischemic stroke was 1.53%, which is 77% lower than the 6.64% risk predicted by the patients' CHA2DS2-VASc scores.  Over 1 year, 8.52% of patients died, and 6.2% suffered major bleeding.  The investigators concluded that the LAAO Registry results support the one-year efficacy and safety of the WATCHMAN device.  In particular, the majority of this patient population had contraindications to anticoagulation, unlike the patients in the previous PROTECT-AF and PREVAIL trials. 

Price MJ, et al. 

All Editors: Andrew M. Goldsweig, MD, MSC, RPVI, FSCAI