Anesthesia for Watchman Procedure

Atrial fibrillation (AF), a common arrhythmia in adults, is characterized by an irregularly irregular rhythm and loss of effective atrial contraction. With loss of atrial contraction, blood stasis in the atrial appendage promotes thrombus formation and an increased risk of thromboembolism and ischemic stroke. Traditionally, long-term oral anticoagulation therapy was used to decrease the incidence of AF ischemic stroke, but its use is associated with bleeding complications. Percutaneous left atrial appendage (LAA) occlusion is a relatively new procedure aimed at preventing thromboembolism and reducing bleeding risk. The most commonly used LAA occlusion device is the Watchman® (Boston Scientific, Natick, MA, USA). This chapter gives an overview of the anesthetic management of this procedure.