Life in the left atrial appendage fast lane after FDA approval: Moving forward on new technology at last

FDA approval of the WATCHMAN is expected to spur development and availability of a range of evolutionary and revolutionary technologies for left atrial appendage occlusion. The fourth generation WATCHMAN described in this article has multiple features that will potentially streamline the deployment process and have the potential to make left atrial appendage occlusion safer. The population studied was too small to compare the relatively high adverse event rate with the known outcomes associated with existing WATCHMAN technology. Going forward, in part because of improvements in technology, it is likely that late ischemic stroke will supplant pericardial effusion as a key outcome measure for ongoing assessment of WATCHMAN safety and efficacy.