TDNet Discover

Objective: Stroke is a major complication of patients with non-valvular atrial fibrillation, a common dysrhythmia. This study evaluated the efficacy of stroke prevention when using the Watchman left atrial appendage closure device and compared it to the outcomes of warfarin anticoagulation therapy in patients with non-valvular atrial fibrillation. Methods: The researchers synthesized a clear set of inclusion and exclusion criteria and applied these terms when searching highly reputable electronic databases for suitable articles. The returned articles then underwent independent screening by the researchers via title and abstract review for applicability to the study, and meetings were held routinely to ensure consensus. Utilization of a proven quality assessment tool assisted in the final selection of articles for inclusion. Ultimately, the researchers chose one systematic review and two systematic reviews and meta-analyses for further study. Conclusions: Responses to the research question were found to be inconsistent within the studies analyzed. Notable data from large randomized control trials demonstrated the Watchman device was a noninferior treatment modality in stroke prevention when compared to warfarin therapy. Other studies, however, were not as firm on this result and deemed further research necessary prior to making any definitive claim. After diligent review and comparative analysis of these distinguished studies, the researchers agreed that while a large amount of data exists on warfarin anticoagulation, data regarding the Watchman device is lacking due to its novel nature. The researchers concurred that while some information regarding the effectiveness of the Watchman device exists, the results are from short-term studies and are limited in their scope. Further study regarding the direct efficacy between the Watchman and warfarin anticoagulation is necessary to narrow confidence intervals and thus increase result reliability in both the short and long-term prevention of stroke.