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Updated: Mar 8, 2026
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
Five years of keeping a watch on the left atrial appendage-how has the WATCHMAN fared?
Mohammad-Ali Jazayeri1, Venkat Vuddanda1, Valay Parikh1
1Division of Cardiovascular Diseases, Center for Excellence in Atrial Fibrillation & EP Research, Bloch Heart Rhythm Center, Cardiovascular Research Institute, University of Kansas Medical Center, Mid America Cardiology, University of Kansas Hospitals, Kansas City, KS, USA.
Insights
Left atrial appendage closure (LAAC) offers stroke prevention for non-valvular atrial fibrillation (AF) patients unsuitable for anticoagulation. This review details WATCHMAN™ device evolution, outcomes, and challenges in appendageology.
Area of Science:
- Cardiology
- Medical Devices
- Interventional Cardiology
Background:
- Left atrial appendage closure (LAAC) is an alternative stroke prevention strategy for patients with non-valvular atrial fibrillation (AF) who cannot tolerate long-term oral anticoagulation.
- Various LAAC methods exist, with percutaneous endocardial occluder devices like WATCHMAN™ gaining prominence.
- Growing experience with LAAC has identified challenges such as device-related thrombi and peri-device leaks, requiring further investigation.
Purpose of the Study:
- To review the evolution and long-term outcomes of the WATCHMAN™ device for LAAC.
- To emphasize the nuances in the use of the WATCHMAN™ device.
- To discuss the role of WATCHMAN™ within the broader field of appendageology.
Main Methods:
- Review of existing literature and clinical data on the WATCHMAN™ device.
- Analysis of evidence regarding LAAC techniques and outcomes.
- Discussion of challenges and ongoing research in LAAC.
Main Results:
- The WATCHMAN™ device has evolved as a significant LAAC modality.
- Long-term outcomes and specific use-case nuances are increasingly understood.
- Device-related thrombi and peri-device leaks remain areas of active investigation and management.
Conclusions:
- LAAC, particularly with devices like WATCHMAN™, is a vital therapy for stroke prevention in specific AF populations.
- Continued research is essential to optimize LAAC techniques and manage associated complications.
- Understanding the long-term implications of LAAC is crucial for patient care and device development.
Abstract:
Left atrial appendage closure (LAAC) is a promising site-directed therapy for stroke prevention in patients with non-valvular atrial fibrillation (AF) who are ineligible or contraindicated for long-term oral anticoagulation. A variety of LAAC modalities are available, including percutaneous endocardial occluder devices such as WATCHMANTM (Boston Scientific Corp., Marlborough, MA, USA), and an ever-increasing body of evidence is helping to define the optimal use of each technique. Similarly increased experience with LAAC has revealed challenges such as device-related thrombi and peri-device leaks for which the long-term significance and appropriate management are areas of active investigation. We review the evolution and long-term outcomes with the WATCHMANTM device with particular emphasis on the nuances of its use and its role in the broader landscape of appendageology.
