EWOLUTION

What is it about?

We describe the implant success and safety of left atrial appendage closure with the WATCHMAN device during the first 30-day follow-up. The data were gathered in the largest prospective real world EWOLUTION registry. We observed that the adverse event rate was lower and the implant success was higher than in previous Watchman trials, despite the fact that in the EWOLUTION population 60% had a contra-indication for oral anti-coagulation, while the CHA2DS2-VASc stroke risk was higher.

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Why is it important?

In prior trials, the advantage of LAA occlusion over the risks of using oral anticoagulation were off-set by a relatively high number of peri-procedural adverse events. The present results show that with increased operator experience, the net clinical benefit of this therapy is increased. Also, this registry provides the largest database to date on the use of Watchman specifically in patients with a contra-indication for anti-coagulation (>600 pts). Although current guidelines promote LAA occlusion specifically for this indication, so far only very limited data were available for this group.