Evaluation of the WATCHMAN Left Atrial Appendage (LAA) Closure Device in Patients With Atrial Fibrillation Versus Long Term Warfarin Therapy

Prospective Randomized Evaluation of the WATCHMAN LAA Closure Device in Patients With Atrial Fibrillation (AF) Versus Long Term Warfarin Therapy

This was a prospective, randomized, multicenter study to provide additional information on the safety and efficacy of the WATCHMAN LAA Closure Technology. The purpose of the PREVAIL study was to confirm the efficacy endpoint as demonstrated in the PROTECT AF pivotal study and to further demonstrate that the WATCHMAN LAA Closure Technology is safe and effective in subjects with non-valvular atrial fibrillation who require anticoagulation therapy for potential thrombus formation.

Key Inclusion Criteria:

• Paroxysmal, persistent or permanent non-valvular AF

• Eligible for long-term warfarin therapy

• Eligible to come off warfarin therapy

• Calculated CHADS2 score of 2 or greater. Also patients with a CHADS2 score of 1 may be included if any of the following apply:

  • Female age 75 or older
  • Baseline LVEF ≥ 30 and < 35%
  • Aged 65-74 and has diabetes or coronary artery disease
  • Aged 65 or greater and has congestive heart failure

Key Exclusion Criteria:

• Contraindicated/allergic to aspirin
• Indicated for clopidogrel therapy or has taken clopidogrel within 7 days prior to enrollment
• History of atrial septal repair or has an ASD/PFO device
• Implanted mechanical valve prosthesis
• NYHA Class IV CHF
• Resting heart rate > 110 bpm
• Participated previously in the PROTECT AF or CAP Registry studies

Key Echo Exclusion Criteria:

• LVEF < 30%
• Existing pericardial effusion > 2mm
• High risk PFO
• Significant mitral valve stenosis
• Complex atheroma with mobile plaque of the descending aorta and/or aortic arch
• Cardiac tumor