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. 2024 Oct 1;4(10):777–790. doi: 10.1016/j.jacasi.2024.07.013

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© 2024 The Authors

This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

PMC Copyright notice

Central Illustration — Procedure Configurations, Medications, and Outcomes Post–Left Atrial Appendage Occlusion

(A) Brief study flow chart. A total of 3,096 patients were included in RECORD (Registry to Evaluate Chinese Real-World Clinical Outcomes in Patients With Atrial Fibrillation Using the Watchman Left Atrial Appendage Closure Technology), and 97.8% completed the 1-year follow-up. The cumulative event rate of death, stroke, or systemic embolism occurred in 4.5% of patients at 1 year. (B) Pie charts showing the type of antithrombotic medication of patients at discharge and 1.5, 6, and 12 months postprocedure. Warfarin or DOAC monotherapy was used in ∼80% of patients at discharge, and single-antiplatelet therapy was used in ∼60% of patients at 12 months postprocedure. (C) The impact of the periprocedural configurations is shown by the forest plot. Although the type of anesthesia or the type of imaging guidance had nonsignificant impact on the prognosis of patients at 12 months postprocedure, complete sealing (in comparison with incomplete sealing) and LAAO in combination with catheter ablation (in comparison with LAAO only) were both associated with lower risk of net adverse cardiovascular events (a composite endpoint including death; stroke; systemic embolism; and any life-threatening, disabling, or major bleeding). APT = antiplatelet therapy; DAPT = dual antiplatelet therapy; (D)OAC = (direct) oral anticoagulants; FU = follow-up; ICE = intracardiac echocardiography; IPW = inverse probability of treatment weighting; LAAO = left atrial appendage occlusion; SAPT = single-antiplatelet therapy; TEE = transesophageal echocardiography.

Central Illustration — Procedure Configurations, Medications, and Outcomes Post–Left Atrial Appendage Occlusion

(A) Brief study flow chart. A total of 3,096 patients were included in RECORD (Registry to Evaluate Chinese Real-World Clinical Outcomes in Patients With Atrial Fibrillation Using the Watchman Left Atrial Appendage Closure Technology), and 97.8% completed the 1-year follow-up. The cumulative event rate of death, stroke, or systemic embolism occurred in 4.5% of patients at 1 year. (B) Pie charts showing the type of antithrombotic medication of patients at discharge and 1.5, 6, and 12 months postprocedure. Warfarin or DOAC monotherapy was used in ∼80% of patients at discharge, and single-antiplatelet therapy was used in ∼60% of patients at 12 months postprocedure. (C) The impact of the periprocedural configurations is shown by the forest plot. Although the type of anesthesia or the type of imaging guidance had nonsignificant impact on the prognosis of patients at 12 months postprocedure, complete sealing (in comparison with incomplete sealing) and LAAO in combination with catheter ablation (in comparison with LAAO only) were both associated with lower risk of net adverse cardiovascular events (a composite endpoint including death; stroke; systemic embolism; and any life-threatening, disabling, or major bleeding). APT = antiplatelet therapy; DAPT = dual antiplatelet therapy; (D)OAC = (direct) oral anticoagulants; FU = follow-up; ICE = intracardiac echocardiography; IPW = inverse probability of treatment weighting; LAAO = left atrial appendage occlusion; SAPT = single-antiplatelet therapy; TEE = transesophageal echocardiography.