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Updated: Sep 25, 2025
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
Comparison between Amplatzer and Watchman Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial
Jianzhong Qiao1, Bin Zhang1, Jie Wang1
1Department of Cardiology, Tongling People's Hospital, Tongling, China.
Insights
The Amplatzer left atrial appendage closure (LAAC) device has higher complication rates, while the Watchman LAAC device shows increased peridevice leak and thrombus. Both devices demonstrated comparable outcomes for stroke, death, and bleeding events.
Area of Science:
- Cardiology
- Medical Devices
- Interventional Cardiology
Background:
- Left atrial appendage closure (LAAC) is crucial for stroke prevention in patients with atrial fibrillation.
- Amplatzer and Watchman are leading LAAC devices globally, necessitating comparative safety and efficacy analysis.
Approach:
- A comprehensive meta-analysis was conducted, synthesizing data from 15 studies.
- Included 2,150 patients from randomized controlled trials and 2,526 from observational studies up to February 2022.
- Searched PubMed, EMBASE, and Cochrane Library databases for relevant comparative studies.
Key Points:
- Amplatzer LAAC device linked to higher major procedure-related complications and device embolization.
- Amplatzer LAAC device showed lower rates of peridevice leak (PDL) and device-related thrombus (DRT).
- Watchman LAAC device associated with increased PDL and DRT.
Conclusions:
- No significant differences observed between Amplatzer and Watchman LAAC devices regarding stroke, death, or bleeding.
- Device selection may depend on balancing procedural risks against long-term complication rates like PDL and DRT.
Introduction:
The Amplatzer and Watchman left atrial appendage closure (LAAC) devices are the two most frequently used devices for LAAC devices worldwide. This meta-analysis aimed to compare the safety and efficacy of the two devices.
Methods:
We searched the PubMed, EMBASE, and the Cochrane Library for studies up to February 6, 2022 that compared the safety and efficacy of the Amplatzer and Watchman devices.
Results:
Fifteen studies including 2,150 patients in randomized controlled trials and 2,526 patients in observational studies were included in the meta-analysis. Amplatzer device was associated with higher rates of major procedure-related complications (odds ratio [OR]: 1.99, 95% confidence interval [CI]: 1.45-2.74, p < 0.0001) and device embolization (OR: 1.99, 95% CI: 1.09-3.64, p = 0.03). However, Amplatzer device had lower rates of total peridevice leak (PDL) (OR: 0.48, 95% CI: 0.27-0.83, p = 0.009), significant PDL (OR: 0.27, 95% CI: 0.12-0.57, p = 0.0007) and device-related thrombus (DRT) (OR: 0.67, 95% CI: 0.48-0.95, p = 0.02). No statistical differences were observed between the two devices in other safety and efficacy endpoints, such as pericardial effusion, cardiac tamponade, air embolism, vascular complications, ischemic stroke/transient ischemic attack (TIA), hemorrhagic stroke, all-cause death, cardiovascular death, and bleeding.
Conclusions:
Amplatzer LAAC device was associated with higher rates of major procedure-related complications, especially in device embolization. Watchman LAAC device was associated with higher rates of PDL and DRT. There were no significant differences between two devices in ischemic stroke/TIA, hemorrhagic stroke, all-cause death, cardiovascular death, and bleeding.
