Related Experiment Video
Updated: Dec 20, 2025
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
WATCHMAN versus ACP or Amulet devices for left atrial appendage occlusion: a sub-analysis of the multicentre LAARGE
Jakob Ledwoch1, Jennifer Franke, Ibrahim Akin
1CardioVascular Center CVC, Frankfurt, Germany.
Insights
This study compared two left atrial appendage closure devices, WATCHMAN and AMPLATZER Cardiac Plug/Amulet, finding comparable safety and effectiveness in real-world practice. Both devices demonstrated high success rates for preventing stroke and death one year post-procedure.
Area of Science:
- Cardiology
- Medical Devices
- Clinical Practice
Background:
- Left atrial appendage (LAA) closure is crucial for stroke prevention in patients with atrial fibrillation.
- Existing LAA closure devices have varying designs, necessitating real-world effectiveness comparisons.
- Generalizing trial results from one device to another is not always appropriate due to design differences.
Purpose of the Study:
- To compare the clinical performance of two contemporary LAA closure devices: WATCHMAN and AMPLATZER Cardiac Plug (ACP)/Amulet.
- To assess procedural success, safety, and one-year effectiveness of these devices in a real-world setting.
- To provide data for informed clinical decision-making regarding LAA closure strategies.
Main Methods:
- A non-randomized sub-analysis of the prospective, multicentre Left-Atrium-Appendage Occluder Register - GErmany (LAARGE) registry.
- Inclusion of 641 patients across 38 centres, divided into WATCHMAN (n=278) and ACP/Amulet (n=340) groups.
- Assessment of technical success, procedural safety, and Kaplan-Meier estimated one-year composite of death or stroke.
Main Results:
- High technical success rates were observed for both devices (96% WATCHMAN vs. 99% ACP/Amulet; p=0.007).
- Procedural safety was comparable between the groups (98% WATCHMAN vs. 97% ACP/Amulet; p=0.55).
- One-year composite rates of death or stroke were similar (12.0% WATCHMAN vs. 12.9% ACP/Amulet; p=0.79).
Conclusions:
- Both WATCHMAN and ACP/Amulet occluders demonstrate excellent procedural outcomes.
- Comparable implantation success and procedural safety were achieved with both devices.
- No significant differences in long-term effectiveness (death or stroke) were observed between the WATCHMAN and ACP/Amulet occluders.
Aims:
Several left atrial appendage (LAA) closure systems are available. Due to differences in device design, the results of specific occluders derived from trials cannot simply be generalised to all devices. The present analysis sought to assess two contemporary LAA closure devices in clinical practice.
Methods And Results:
The work represents a non-randomised sub-analysis of the prospective, multicentre, Left-Atrium-Appendage Occluder Register - GErmany (LAARGE) registry. The WATCHMAN (group 1) and the AMPLATZER Cardiac Plug (ACP) or Amulet occluder (group 2) were assessed. A total of 641 patients at 38 centres were enrolled. Of these, 278 (43%) and 340 (53%) patients received the WATCHMAN and ACP/Amulet occluder, respectively. High technical success was achieved with a slight difference between the groups (96% in group 1 vs 99% in group 2; p=0.007). Procedural safety did not differ (98% in group 1 vs 97% in group 2; p=0.55). The Kaplan-Meier estimated one-year composite of death or stroke was 12.0% and 12.9%, respectively (p=0.79).
Conclusions:
Both the WATCHMAN and the ACP/Amulet occluder provide excellent procedural results with comparable implantation success and no differences with respect to procedural safety and long-term effectiveness.
