Clinical Electrophysiology -> Atrial Fibrillation & Atrial Flutter: -> Left Atrial Appendage Closure D-AB28 - Left Atrial Appendage Closure- Trials and Tribulations (ID 32) Abstract Plus

D-AB28-01 - Indications For Watchman Left Atrial Appendage Occlusion In The United States: Results From The National Cardiovascular Data Registry - Left Atrial Appendage Occlusion Registry (ID 808)


Background: The indications for left atrial appendage occlusion (LAAO) with the WATCHMAN device in a real-world setting across the United States have not previously been reported.
Objective: To characterize patients who have undergone WATCHMAN implantation and describe indications for the procedure in clinical practice in the United States
Methods: We studied the clinical characteristics and procedural indications of 35,568 patients in the NCDR LAAO Registry undergoing WATCHMAN implantation between January 1, 2016 and December 31, 2018.
Results: The mean patient age was 76 ± 8.1 years; 92.6% were white and 58.9% were male. The mean CHA2DS2-VASc score was 4.8 ± 1.5, while mean HAS-BLED score was 3.0 ± 1.1. Prior stroke or TIA was reported in 39.8% of patients. The most commonly documented indications included increased thromboembolic risk (65.0%), history of major bleed (64.2%), high fall risk (35.5%), and patient preference (34.0%) [Figure 1A]. The most commonly cited types of bleeding history were gastrointestinal (41.7%), intracranial (11.8%), and other clinically relevant bleeding (15.0%) [Figure 1B]. Most of the population (72.1%) had at least two indications for the WATCHMAN, while 31.0% had three or more indications.
Conclusion: Among patients in the NCDR LAAO Registry, the mean CHA2DS2-VASc score was high, with a considerable portion of patients having had prior stroke or TIA. The most common indications for WATCHMAN implantation were increased thromboembolic risk, history of GI bleed, and high fall risk.