For patients with symptomatic atrial fibrillation (AF), physicians typically offer AF ablation for symptom relief; however, patients often anticipate/expect a life free from anticoagulation. This belief puts patients at increased risk of stroke due to the potential for asymptomatic AF post-ablation if anticoagulation is ceased contrary to clinical guidelines. Although the WATCHMAN device has been FDA-approved to decrease the risk of thromboembolism from the left atrial appendage (LAA) in patients with an appropriate rationale to avoid oral anticoagulation, it has not been well-studied following AF ablation. Additionally, there are limited data comparing the WATCHMAN device to direct oral anticoagulants. The OPTION study will investigate whether LAA closure with the WATCHMAN FLX device is a reasonable alternative to oral anticoagulation following percutaneous catheter ablation for nonvalvular AF.
Reference: Comparison of Anticoagulation with Left Atrial Appendage Closure after AF Ablation: Rationale and Design of the OPTION randomized trial. Wazni O, Boersma L, Healey JS, Mansour M, Tondo C, Phillips K, Doshi R, Jaber W, Hynes E, Allocco DJ, Reddy VY. Am Heart J. 2022 May 5:S0002-8703(22)00088-6.