AIM To analyze the effects of Watchman left atrial appendage closure (LAAC) and oral rivaroxaban on stroke prevention in patients with non-valvular atrial fibrillation (NVAF).
METHODS 30 NVAF patients treated with LAAC in the Department of Cardiovascular Medicine of the People's Hospital of Liaoning Province and the First Affiliated Hospital of Dalian Medical University from May 2016 to March 2017 were selected as LAAC treatment group, and 30 NVAF patients treated with rivaroxaban in the same period were selected as rivaroxaban treatment group. The safety and effectiveness of the two groups were evaluated at the first, third, sixth, ninth, twelfth months after discharge and every six months after discharge. The follow-up period was up to 31 March 2019.
RESULTS The follow-up results of NVAF patients in two groups showed that there were no ischemic stroke, hemorrhagic stroke and systemic embolism in LAAC treatment group, there were 2 cases of ischemic stroke, 2 cases of systemic embolism and 1 case of hemorrhagic stroke in rivaroxaban treatment group, although there was no significant difference in the incidence of individual cardiovascular events between the two groups, however, the total incidence of cardiovascular events in LAAC group was significantly lower than that in Rivaroxaban group. There were no intracranial hemorrhage, embolism and clinically related stroke in LAAC treatment group, and no gastrointestinal hemorrhage occurred; while in rivaroxaban treatment group, 1 case had intracranial hemorrhage, 2 cases had embolism, no gastrointestinal hemorrhage occurred and 3 cases had clinically related stroke; there was no significant difference in the incidences of adverse events between the two groups, but the total incidence of adverse events in LAAC group was significantly lower than that in Rivaroxaban group (P > 0.05). All the patients in LAAC treatment group were successfully implanted with Watchman left atrial appendage occluder, there were 9 cases of residual shunt and no severe residual shunt ( > 5 mm). No device displacement or device thrombosis occurred in the patients.
CONCLUSION The effectiveness and safety of Watchman LAAC in the prevention of stroke in NVAF patients are better than those of Rivaroxaban.
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