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Updated: Mar 29, 2026
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
Transcatheter closure of the left atrial appendage: initial experience with the WATCHMAN device
Jiandong Ding1, Jian Zhu1, Jing Lu1
1Department of Cardiology, Zhongda Hospital & School of Clinical Medicine Southeast University Nanjing, China.
Insights
Left atrial appendage closure using the WATCHMAN device is a safe and feasible alternative for patients with atrial fibrillation ineligible for anticoagulation. This procedure effectively prevented thromboembolic events in a short-term follow-up study.
Area of Science:
- Cardiology
- Interventional Cardiology
- Electrophysiology
Background:
- Atrial fibrillation (AF) is a common arrhythmia, with left atrial appendage (LAA) thrombi posing a significant stroke risk.
- Warfarin is a standard anticoagulant but carries risks of bleeding and drug interactions.
- Percutaneous LAA closure offers an alternative for high-risk AF patients.
Purpose of the Study:
- To evaluate the safety and efficacy of percutaneous LAA closure using the WATCHMAN device.
- To assess the device as an alternative to anticoagulation in specific AF patient populations.
Main Methods:
- Patients with AF and CHADSVASc score ≥ 2, unsuitable for anticoagulation, underwent LAA closure with the WATCHMAN device.
- Procedures were performed under general anesthesia, guided by fluoroscopy and transesophageal echocardiography.
Main Results:
- Successful percutaneous LAA closure was achieved in all patients.
- No major adverse events, including thromboembolic events, were observed at 45-day follow-up.
Conclusions:
- Transcatheter LAA closure with the WATCHMAN device is a safe and feasible option.
- Further long-term studies are needed to fully understand the risks and benefits of this therapy.
Background:
Atrial fibrillation (AF) is the most commonly encountered clinical arrhythmia, accounting for approximately one third of hospitalizations for cardiac rhythm disturbance. In patients with non-valvular AF, approximately 90% of thrombi are thought to arise from the left atrial appendage (LAA). Anticoagulation with warfarin has been the mainstay of therapy to reduce stroke risk in these patients; however, it is not without its complications including bleeding and drug interactions. Percutaneous left atrial appendage closure can be an alternative to warfarin treatment in patients with AF at high risk for thromboembolic events and/or bleeding complications.
Methods:
Patients with atrial fibrillation and CHADSVASc score ≥ 2, not eligible for anticoagulation, were submitted to left atrial appendage closure using the WATCHMAN device. The procedure was performed under general anaesthesia, and was guided by fluoroscopy and transoesophageal echocardiography.
Results:
Percutaneous LAA closure with the WATCHMAN device was performed in all patients. At 45-day follow-up no recurrent major adverse events and especially no thromboembolic events occurred.
Conclusions:
Transcatheter closure of the LAA with the WATCHMAN device is generally safe and feasible. Long-term follow-up will further reveal the risk and benefits of this therapy.
