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Updated: Aug 8, 2026
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
Left atrial appendage closure - new choice for no-option patients with atrial fibrillation
M Grygier1, A Olasinska-Wisniewska, O Trojnarska
1First Department of Cardiology, Poznan University of Medical Sciences, Poznan, Poland - anna.olasinska@poczta.onet.pl.
Insights
Left atrial appendage closure offers a safe alternative for patients with atrial fibrillation who cannot tolerate oral anticoagulation. Devices like Watchman and Amplatzer Cardiac Plug effectively reduce thromboembolic risks.
Area of Science:
- Cardiology
- Medical Devices
- Thrombosis Research
Background:
- Atrial fibrillation (AF) is associated with left atrial appendage (LAA) remodeling and impaired blood flow, increasing thrombus formation and thromboembolic risks.
- Pharmacological antithrombotic therapies are not suitable for all AF patients due to comorbidities or contraindications.
Purpose of the Study:
- To evaluate the early clinical experience with two transcatheter left atrial appendage closure systems: Watchman and Amplatzer Cardiac Plug.
- To assess the safety and efficacy of LAA closure as an alternative to oral anticoagulation in high-risk AF patients.
Main Methods:
- Twenty-three patients with non-rheumatic AF and high thromboembolic risk (CHA2DS2-VASc score ≥2) unsuitable for oral anticoagulation were included.
- Procedures involved implantation of either the Amplatzer Cardiac Plug (n=7) or Watchman Occluder (n=15).
- One patient did not undergo implantation due to LAA thrombus identified during the procedure.
Main Results:
- Successful implantation was achieved in 22 out of 23 patients.
- No severe pericardial effusion or device-related thrombus was observed during follow-up.
- One patient experienced a transient ischemic attack, and one died from a non-cardiac cause 14 months post-procedure.
Conclusions:
- Left atrial appendage occluder implantation is a safe and viable alternative to oral anticoagulation for selected AF patients.
- LAA closure should be considered for patients with AF experiencing contraindications or complications with pharmacological antithrombotic treatments.
Aim:
Remodeling and impaired blood flow in left atrial appendage (LAA), which occurs in patients with atrial fibrillation (AF), may lead to thrombus formation and possible thromboembolic complications. Although there are several pharmacological antithrombotic possibilities, some patients with several co-morbidities and contraindications to such treatment cannot be offered any of them. Therefore LAA closure systems may be an attractive alternative. We present our early experience with two currently available different LAA transcatheter closure systems (Watchman and Amplatzer Cardiac Plug).
Methods:
Twenty three patients (mean age 69.1±6.8 years, 12 male) with non-rheumatic AF and high risk of thromboembolic complications (CHA2DS2-VASc score ≥2 (mean 4.5±1.5), who could not be treated with the long-term oral anticoagulation because of contraindications or significant side effects, were qualified to the LAA closure.
Results:
The Amplatzer Cardiac Plug (St Jude Medical, St Paul, MN, USA) was implanted in 7 patients and Watchman Occluder (Boston Scientific, Boston, MA, USA) in the other 15 patients. The implantation was not performed in one patient as the transoesophageal echocardiography during the procedure revealed a new thrombus in LAA. The procedural details and follow-up data are presented. Neither severe pericardial effusion nor device related thrombus were observed. In long term follow-up transient ischemic attack was noted only in one patient (diagnosed with thrombophilia). One patient died 14 months after the procedure due to non-cardiac reason.
Conclusion:
The LAA occluder implantation seems to be a safe and reasonable alternative for oral anticoagulation and should be considered in patients with AF who have contraindications or complications of pharmacological treatment.
