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Updated: Oct 1, 2025
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
Left atrial appendage closure with Watchman device: Insights from the first-ever Tunisian experience and six-year
Insights
Left atrial appendage (LAA) closure using the Watchman device offers a safe and effective stroke prevention method for nonvalvular atrial fibrillation (AF) patients unsuitable for oral anticoagulation (OAC). Long-term follow-up confirmed no strokes or device issues.
Area of Science:
- Cardiology
- Medical Devices
- Interventional Cardiology
Background:
- Stroke is a significant complication of nonvalvular atrial fibrillation (AF).
- Oral anticoagulation (OAC) effectively prevents stroke but increases bleeding risk.
- Percutaneous left atrial appendage (LAA) closure is an alternative stroke prevention strategy.
Purpose of the Study:
- To assess the short- and long-term outcomes of percutaneous LAA closure in Tunisian patients with nonvalvular AF.
- Evaluate the safety and efficacy of the Watchman device for LAA closure.
Main Methods:
- Prospective enrollment of 19 nonvalvular AF patients undergoing percutaneous LAA closure with the Watchman device.
- Clinical and echocardiographic follow-up at 1, 6, 12 months, and annually up to 6 years.
- Assessment of patient demographics, comorbidities (hypertension, diabetes), stroke/TIA history, and bleeding risk scores (CHA2DS2VASc, HAS-BLED).
Main Results:
- Procedural success was achieved in all patients.
- One case of pericardial effusion with tamponade occurred; no post-procedural deaths.
- No strokes, thromboembolic events, or Watchman device thrombosis were reported during up to 6 years of follow-up.
- Three deaths occurred due to respiratory issues and cancer.
Conclusions:
- Percutaneous LAA closure with the Watchman device is safe and effective for stroke prevention in nonvalvular AF patients with contraindications to OAC.
- The procedure demonstrated favorable long-term outcomes, including a lack of device-related complications or embolic events.
Background:
Stroke is a major complication of nonvalvular atrial fibrillation (AF). Despite its proven efficacy in stroke prevention, oral anticoagulation (OAC) is associated to a significant increase in bleeding complications. New techniques such as percutaneous left atrial appendage (LAA) closure were developed.
Aim:
To evaluate immediate, mid- and long-term outcomes after percutaneous LAA closure in Tunisian patients presenting with nonvalvular AF.
Methods And Results:
Nineteen patients with nonvalvular AF were prospectively enrolled for percutaneous LAA closure between February 2013 and June 2014. The Watchman device was used in all LAA closure procedures. Clinical and echocardiographic follow-up were carried-out at 1, 6, 12 months and six years in all patients. Mean age was 68.4 ± 7.5 years. Thirteen patients were female, 16 had hypertension, 12 had diabetes mellitus and seven had a history of stroke or transient ischemic attack (TIA). Average CHA2DS2VASc (Congestive Heart Failure/Left Ventricular Dysfunction, Hypertension, Age≥75, Diabetes mellitus, Stroke/Transient Ischemic Attack/Thromboembolic event, Vascular disease,Age≥65, Sex category) score was 4.2 ± 1.5 and HAS-BLED (Hypertension, Abnormal renal/liver function, Stroke, Bleeding tendency, Labile INR, Age≥65, Drugs) score was 3.5 ± 1. Ten patients had a history of severe bleeding. Procedural success was achieved in all patients. Pericardial effusion with tamponade was reported in one case. No post-procedural death was reported. Regular follow-up at 1, 6 and12 months then every year up to 6 years reported no stroke, no thromboembolic event, no Watchman device thrombosis and three cases of death caused by a respiratory problem and cancers.
Conclusion:
According to this study, LAA closure with Watchman device was safe and effective in preventing stroke in patients with nonvalvular AF and contra indication to OAC.
