Shephal Doshi CHAMPION-AF trial may help expand use of LAAO in non-bleeding risk patients

One of the most anticipated late-breaking trials presented at ACC.26 in New Orleans was CHAMPION-AF, which showed left atrial appendage occlusion (LAAO) can provide a safe alternative to anticoagulation therapy for patients with atrial fibrillation who are not at a high risk of bleeding.

First author Shephal Doshi, MD, an electrophysiologist at Cedars Sinai Smidt Heart Institute, spoke to Cardiovascular Business about the trial during the conference.

"In terms of efficacy, LAA closure was non-inferior to anticoagulation when you combine those three endpoints of stroke, cardiovascular death and systemic embolism. And the p-value was statistically significant, being less than 0.01. From a safety standpoint, LAA closure was superior to anticoagulant therapy in terms of bleeding," Doshi explained.

The trial enrolled approximately 3,000 patients randomized to receive either LAAO using the Watchman FLX device or standard anticoagulation therapy with non-vitamin K oral anticoagulants (NOACs).

Importantly, LAAO outperformed anticoagulation on safety in bleeding events. This finding is notable because the study population consisted of patients who traditionally face low risk of bleeding complications.