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Updated: Aug 20, 2025
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Combined atrial fibrillation ablation and left atrial appendage closure: Watchman vs. LAmbre devices
Jin-Yan Ke1, Lu-Shen Jin1, Yuan-Nan Lin1
1Department of Cardiology, Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
Insights
The Watchman and LAmbre devices show similar efficacy and safety for combined left atrial appendage closure and ablation in atrial fibrillation patients. However, LAmbre had a higher rate of minimal peri-device leakage on follow-up imaging.
Area of Science:
- Cardiology
- Medical Devices
- Interventional Procedures
Background:
- Non-valvular atrial fibrillation (AF) management often involves anticoagulation.
- Left atrial appendage closure (LAAC) combined with radiofrequency catheter ablation offers a hybrid approach.
- This study compares two LAAC devices, Watchman and LAmbre, in this combined procedure.
Purpose of the Study:
- To compare the efficacy and safety of the Watchman device versus the LAmbre device for LAAC combined with radiofrequency catheter ablation.
- To evaluate periprocedural and follow-up adverse events in patients undergoing this hybrid procedure.
Main Methods:
- A total of 232 patients with AF were enrolled and divided into Watchman-combined (n=118) and LAmbre-combined (n=114) groups.
- Periprocedural and follow-up adverse events, including major complications, AF recurrence, and peri-device leakage (PDL), were documented.
- Follow-up included transesophageal echocardiography (TEE) at 3-6 months.
Main Results:
- Successful LAAC was achieved in all patients, with comparable CHA2DS2-VASc and HAS-BLED scores between groups.
- Major periprocedural complications and 6-month AF recurrence rates were similar (0.8% vs 0.9% and 22.0% vs 15.8%, respectively).
- Long-term major clinical adverse events (stroke, bleeding) were comparable (2.6% vs 1.1% per 100 patient-years). Intraprocedural PDL rates were similar (5.1% vs 6.1%), but minimal PDL at 3-6 months TEE was higher in the LAmbre group (36.6% vs 21.6%).
Conclusions:
- The Watchman and LAmbre devices demonstrate comparable efficacy and safety for the combined LAAC and ablation procedure.
- A higher rate of minimal peri-device leakage was observed with the LAmbre device at short-term TEE follow-up compared to the Watchman device.
Background:
Left atrial appendage closure (LAAC) combined with radiofrequency catheter ablation is an emerging one-stop hybrid procedure for non-valvular atrial fibrillation (AF). This study was performed to compare the efficacy and safety of the Watchman device vs. the LAmbre device for this combined procedure.
Methods:
Two hundred and thirty two patients with AF who underwent the combined procedure were enrolled and divided into two subgroups depending on the device choice: the Watchman-combined group (n = 118) and the LAmbre-combined group (n = 114). The periprocedural and follow-up adverse events in both groups were documented.
Results:
The mean CHA2DS2-VASc score and HAS-BLED score in the Watchman-combined group and LAmbre-combined group were 3.7 ± 1.5 vs. 3.8 ± 1.5 and 2.5 ± 1.1 vs. 2.3 ± 1.1, respectively (all P > 0.05). Successful LAAC was achieved in all patients. The rate of major periprocedural complications and AF recurrence at 6 months post-procedure were similar between the Watchman-combined group and LAmbre-combined group (0.8 vs. 0.9%, P = 1.00; 22.0 vs. 15.8%, P = 0.23). During 2.6 ±0 .7 vs.1.6 ± 1.6 years follow-up, the rate of major clinical adverse events, including stroke and major bleeding, were comparable between the Watchman-combined group and the LAmbre-combined group (2.6 vs. 1.1% per 100 patient-years, P = 0.33). The intraprocedural peri-device leakage (PDL) rate was similar between the Watchman-combined group and the LAmbre-combined group (5.1 vs. 6.1%, P = 0.73), but the PDL rate was significantly higher at 3-6 months transesophageal echocardiography (TEE) follow-up than the intraprocedural PDL rate in both groups (21.6 vs. 5.1%; 36.6 vs. 6.1%, respectively), with a more obvious increase in minimal PDL rate in the LAmbre-combined group than the Watchman-combined group (36.6 vs. 21.6%, P < 0.05).
Conclusion:
The Watchman and LAmbre devices were comparable in efficacy and safety for the combined procedure. The minimal PDL rate at short-term TEE follow-up was higher in the LAmbre-combined group than the Watchman-combined group.
