Left Atrial Appendage Closure in Atrial Fibrillation: A World without Anticoagulation?

Table 3

Studies evaluating percutaneous left atrial appendage closure devices.

No.	Study	Study design	Year	Device	Comparison	Subjects (n)	Population	Followup (mean)	Results	Adverse events
(1)	Meier et al. [36]	Prospective	2003	Amplatzer Septal Occluder	None	16	AF-continuous/paroxysmal; c/i to coumadin	4 months	0% stroke/TIA	Device embolization (1)
(2)	Sievert et al. [37]	Prospective	2002	PLAATO	None	15	Chronic, nonrheumatic AF; c/i to coumadin	1 month	0% stroke/TIA	Hemopericardium (1), device exchange (4)
(3)	Ostermayer et al. [38]	Prospective	2005	PLAATO	None	111	Chronic nonrheumatic AF patients at risk for stroke; c/i to coumadin	10 months	Stroke/TIA 2.2% (versus estimated 6.3%)	Implant failure (3), Hemopericardium (5)
(4)	Block et al. [39]	Prospective	2009	PLAATO	None	64	C/P AF; CHADS2 ≥ 2; c/i to coumadin	5 years	Stroke 3.8% (versus estimated 6.6%)	Cardiac tamponade (1), (%)
(5)	Sick et al. [40]	Prospective	2007	WATCHMAN	None	75	C/P AF; CHADS2 ≥ 1; eligible for coumadin	2 years	0% stroke/TIA	Implant failure (2), device failure, embolization, or pericardial effusion (6), TIA’s (2)
(6)	PROTECT AF [45]	Randomized Controlled Trial	2009	WATCHMAN	Warfarin	707	C/P AF; CHADS2 ≥ 1; eligible for coumadin	18 months	>99% probability of noninferiority for stroke/TIA prevention	Adverse events higher among controls

AF: atrial fibrillation, c/i: contraindication, C/P: Chronic/Paroxysmal, TIA: transient ischemic attack, PLAATO: percutaneous left atrial appendage transcatheter occlusion, and PROTECT AF: WATCHMAN left atrial appendage system for embolic protection in patients with atrial fibrillation.