Promising new methods to reduce risk of stroke in patients with atrial fibrillation

This study aimed to compare the use of new oral anticoagulant drugs (NOACs) and the Watchman implantation device with blood thinner warfarin in patients with artrial fibrillation. The study concluded that both NOACs and the Watchman device are superior to warfarin in reducing the risk of stroke.

Atrial fibrillation (AF) is a common heart problem where the rhythm of the heart is irregular. AF patients are at a much greater risk of stroke. Due to this higher risk, patients are regularly treated with an anticoagulant (drug that thins the blood) known as warfarin (Coumadin) to prevent stroke. Warfarin, however, can increase the chance of bleeding problems. Newer drugs (NOACs) are less likely to increase bleeding risks.

The Watchman device is an implant which blocks off an area of the heart prone to causing strokes in AF patients. It is not clear whether the Watchmen device and NOACs are more effective at preventing stroke than warfarin.

This study reviewed 14 previous studies, including 246,005 patients, comparing warfarin, NOACs and the Watchman device in AF patients. 124,823 patients were treated with warfarin (group 1), 120,450 were treated with NOACs (group 2) and 732 had Watchman implanted (group 3).

Group 2 patients had a 22% decrease in stroke and 22% decrease in bleeding events compared to group 1.

The risk of hemorrhagic stroke (bleeding in the brain due to weakened blood vessel) was 54% lower in group 2 and 79% lower in group 3 compared to group 1.

This study concluded that the Watchman device and NOACs are more efficient than warfarin in stroke prevention.

The study found no significant differences between Watchman and NOACs. These two treatments should be directly compared in further research. In addition, there were only 732 patients with the Watchman device implanted compared to a much greater number of patients treated NOACs and warfarin.