Radiofrequency Energy Applications Targeting Significant Residual Leaks After Watchman Implantation: A Prospective,...

Area of Science:

• Cardiology
• Interventional Cardiology
• Medical Devices

Background:

• Radiofrequency (RF) energy is known to prevent recanalization in intracranial aneurysms.
• RF promotes collagen deposition and tissue retraction, aiding in vessel sealing.
• Previous research suggests RF's potential in promoting tissue remodeling and sealing.

Purpose of the Study:

• To evaluate the efficacy of RF energy applications for residual leaks after left atrial appendage (LAA) occlusion.
• To assess the safety and effectiveness of targeting the atrial side of significant leaks.
• To determine if RF can improve LAA sealing in patients with incomplete occlusion.

Main Methods:

• Forty-three patients with residual leaks (≥4 mm) post-Watchman implantation were enrolled.
• RF leak closure was performed acutely or scheduled based on follow-up transesophageal echocardiography (TEE).
• Procedural success was defined as complete LAA occlusion or minimal leak (<2 mm) on follow-up TEE.

Main Results:

• RF applications (median 5 mm leak size) resulted in a post-procedure median leak size of 0 mm.
• Complete LAA sealing was achieved in 53.5% of patients, with negligible leaks in 34.9%.
• A low rate (2.3%) of major periprocedural complications was observed.

Conclusions:

• RF applications targeting peri-Watchman leaks promote LAA sealing through tissue remodeling.
• This approach appears safe and effective for managing significant residual leaks.
• The REACT trial (NCT04726943) investigated RF for residual LAA leaks.