Q; 64 years old male with a longstanding history of atrial fibrillation is admitted to ICU after WATCHMAN DEVICE implantation. Patient anticoagulation should be stopped onwards?
WATCHMAN device is a percutaneous closure of Left Atrial Appendage (LAA). It is advisable to continue anticoagulation for 6 weeks after the procedure with either warfarin (keeping INR 2-3) or direct oral anticoagulant (DOAC) plus daily aspirin (81 or 325 mg).
If patient can't tolerate anticoagulation dual antiplatelet therapy (DAPT) should be kept on for one-six months (as per the clinician's discretion). Afterward, a patient can be managed only on daily aspirin.
It would be prudent to let the cardiology service manage the anticoagulation.
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