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Comment & Response |

Left Atrial Appendage Closure for Atrial Fibrillation

Claudia Stöllberger, MD1; Birke Schneider, MD2
[+] Author Affiliations
1Krankenanstalt Rudolfstiftung, Wien, Austria
2Sana Kliniken, Lübeck, Germany
JAMA. 2015;313(10):1057. doi:10.1001/jama.2015.0682.
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To the Editor The study by Dr Reddy and colleagues1 reported the 3.8-year follow-up of the PROTECT AF trial that randomized patients with atrial fibrillation (AF) to receive percutaneous left atrial appendage (LAA) closure with the WATCHMAN device or warfarin. We had a number of questions and concerns about the study.

First, patients randomized to receive warfarin were older and more often had cardiovascular comorbidities and permanent AF than the patients randomized to receive the LAA closure. In Table 1 in the article, P values were missing, so it is unclear if these differences were statistically significant and may in part explain the higher mortality in the warfarin group.

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March 10, 2015
Vivek Y. Reddy, MD; David Holmes, MD
1Helmsley Electrophysiology Center, Mount Sinai School of Medicine, New York, New York
2Mayo Clinic College of Medicine, Rochester, Minnesota
JAMA. 2015;313(10):1057-1058. doi:10.1001/jama.2015.0685.
November 19, 2014
Vivek Y. Reddy, MD; Horst Sievert, MD; Jonathan Halperin, MD; Shephal K. Doshi, MD; Maurice Buchbinder, MD; Petr Neuzil, MD, PhD; Kenneth Huber, MD; Brian Whisenant, MD; Saibal Kar, MD; Vijay Swarup, MD; Nicole Gordon, BSEE; David Holmes, MD; for the PROTECT AF Steering Committee and Investigators
1Mount Sinai School of Medicine, New York City, New York2St John’s Health Center, Santa Monica, California3Homolka Hospital, Prague, Czech Republic
4Cardiovascular Center Frankfurt, Sankt Katharinen, Frankfurt, Germany
1Mount Sinai School of Medicine, New York City, New York
2St John’s Health Center, Santa Monica, California
5Foundation for Cardiovascular Medicine, La Jolla, California
3Homolka Hospital, Prague, Czech Republic
6St Luke’s Hospital, Kansas City, Missouri
7Intermountain Medical Center, Murray, Utah
8Cedars Sinai Medical Center, Los Angeles, California
9Arizona Heart Rhythm Center, Scottsdale
10Boston Scientific, St Paul, Minnesota
11Mayo Clinic College of Medicine, Rochester, Minnesota
JAMA. 2014;312(19):1988-1998. doi:10.1001/jama.2014.15192.
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