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The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
23:33

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation

Published on: February 28, 2012

83.6K

Risk factors, clinical implications, and management of peridevice leak following left atrial appendage closure: A

Baraa Helal1, Jibran Khan1, Dalia AlJayar1

  • 1College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.

Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing
|January 5, 2024
PubMed

Insights

Left atrial appendage closure (LAAC) can lead to peri-device leaks (PDL), a complication increasing thromboembolism risk. Identifying PDL risk factors and management strategies is crucial for stroke prevention in atrial fibrillation patients.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Medical Devices

Background:

  • Left atrial appendage closure (LAAC) is a key stroke prevention strategy for atrial fibrillation (AF) patients.
  • Peri-device leaks (PDL) are a potential complication of LAAC, possibly increasing thromboembolism risk.

Approach:

  • A systematic review following PRISMA guidelines was conducted.
  • Eleven databases were searched for primary studies up to April 2022.
  • Studies reporting on PDL characteristics, risk factors, and management were included.

Key Points:

  • 33% of patients in 116 studies (30,133 patients) experienced PDL.
  • Risk factors for PDL include lower device oversizing, reduced ejection fraction, LAA shape mismatch, prior ablation, and male sex.
  • Transesophageal echocardiogram and cardiac CT are primary screening methods; management varies from device adjustment to surgical intervention.

Conclusions:

  • PDL is a significant complication post-LAAC that requires careful consideration.
  • Further research is needed to optimize patient selection, timing, and management strategies for PDL.
Abstract

Keywords:
Atrial fibrillationLeft atrial appendagePeri-device leakWatchman

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