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Updated: Oct 9, 2025
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
The impact of percutaneous left atrial appendage closure on left ventricular diastolic function and natriuretic
C Şabanoğlu1, S Okutucu, I Halil İnanç
1Department of Cardiology, Kirikkale Yuksek Ihtisas Hospital, Kirikkale, Turkey. drchingiz23@gmail.com.
Insights
Left atrial appendage (LAA) closure in atrial fibrillation (AF) patients was associated with impaired diastolic function and elevated B-type natriuretic peptide levels. These findings suggest potential changes in cardiac mechanics post-procedure.
Area of Science:
- Cardiology
- Cardiac Electrophysiology
- Cardiovascular Imaging
Background:
- Left atrial appendage (LAA) closure is established for stroke prevention in atrial fibrillation (AF).
- Limited data exist on the impact of LAA closure on diastolic function.
- Understanding these effects is crucial for comprehensive patient management.
Purpose of the Study:
- To investigate the effect of LAA closure on diastolic function in AF patients.
- To assess changes in natriuretic peptide levels following LAA closure.
Main Methods:
- A cohort of 12 non-valvular AF patients underwent LAA occlusion using the WATCHMAN device.
- Diastolic parameters (mitral inflow, pulmonary vein flow) and B-type natriuretic peptide (BNP) levels were measured.
- Evaluations were performed at baseline and 45 days post-procedure.
Main Results:
- LAA closure led to an increased E/Vp ratio and elevated BNP levels (p=0.015 and p=0.018, respectively).
- Pulmonary vein S wave and S/D ratio decreased significantly post-procedure (p=0.048 and p=0.019, respectively).
- These changes indicate a potential alteration in diastolic function after LAA closure.
Conclusions:
- Percutaneous LAA closure in AF patients was associated with impaired diastolic function.
- Elevated BNP levels were observed post-LAA closure, suggesting cardiac strain.
- Further research is needed to elucidate the long-term implications of these findings.
Objective:
Although the efficacy and safety of left atrial (LA) appendage (LAA) closure in patients with atrial fibrillation (AF) have been well documented in randomized controlled trials and real-world experience, there are limited data in the literature about the impact of LAA closure on diastolic functions. The study aimed to examine the impact of LAA closure on diastolic function and natriuretic peptide levels in patients with AF.
Patients And Methods:
Twelve non-valvular AF patients with high risk for developing cardioembolic stroke and contraindications to warfarin underwent LAA occlusion with the WATCHMAN device (Atritech Inc., Plymouth, MN, USA). B-type natriuretic peptide levels and detailed diastolic parameters (mitral inflow velocities, deceleration time (DT), flow propagation velocity (Vp), isovolumetric relaxation time (IVRT), mitral annular e', TE-e', IVRT/TE-e', E/Vp, E/e', pulmonary vein flow parameters consisting of S, D, and S/D) were evaluated at baseline and 45 days after LAA closure.
Results:
The median age of the patients was 69 (54-78) years and 75% (n: 9) of them were male. All patients completed forty-five days of follow-up. Compared to the baseline values, E/Vp ratio and BNP levels (1.95 (0.94-3.32) vs. 2.37 (1.09-4.46), p= 0.015; 290.0 (90-1271) pg/ml vs. 322.00 (106-1635) pg/ml, p=0.018, respectively) increased, and pulmonary vein S wave and S/D ratio (0.67 (0.33-0.92) vs. 0.38 (0.23-0.91) m/sec, p=0.048; 1.62 (0.86-5.75) vs. 1.33 (0.11-3.35), p=0.019, respectively) decreased after LAA closure.
Conclusions:
In the present study, we demonstrated that patients with AF have shown impaired diastolic functions and elevated BNP levels after the percutaneous closure of the LAA.
