The Efficacy And Safety Of The Watchman Device In Left Atrial Appendage Occlusion In Patients With Non Valvular Atrial Fibrillation Contraindicated To Oral Anticoagulation

The standard treatment for stroke risk patients with nonvalvular atrial fibrillation(NVAF)is the use of oral anticoagulants(OACs).However,a substantial number of patients have relative or absolute contraindications to OACs due to concerns of major bleeding risk and other adverse effects whilst using oral anticoagulation therapy.Recently,occurrences of exclusion of the left atrial appendage(LAA)in patients with contraindication to anticoagulation therapy are widely expanding worldwide,causing major contentious discussions.The LAA is the commonest place of thrombus formation;therefore,the concept of LAA occlusion in reducing stroke and other embolic events in NVAF patients is very important.The current understanding of the available evidence on efficacy and safety of left atrial appendage closure with the Watchman device in patients contraindicated to OACs is the major aim of this focused review.After reviewing a significant body of literature,a world experience with no randomized trials,it is suggested that Watchman device implantation is effective and safe in high risk patients with NVAF contraindicated to OACs therapy.