Related Experiment Video
Updated: Jun 17, 2026
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
Feasibility and Impact of Left Atrial Appendage Closure in Patients with Cardiac Implantable Electronic Devices:
Tommaso Bini1,2, Sven Ledwoch1, Roberto Galea1
1Department of Cardiology, Bern University Hospital, University of Bern, 3010 Bern, Switzerland.
Insights
Percutaneous left atrial appendage (LAA) closure is safe for patients with cardiac implantable electronic devices (CIEDs). However, LAA closure may increase atrial fibrillation burden, warranting further investigation.
Area of Science:
- Cardiology
- Electrophysiology
- Interventional Cardiology
Background:
- Percutaneous left atrial appendage (LAA) closure (LAAC) is an alternative to oral anticoagulation for high-risk bleeding patients with atrial fibrillation (AF).
- The impact of LAAC on AF burden and device function in patients with cardiac implantable electronic devices (CIEDs) is not well understood.
Purpose of the Study:
- To evaluate the safety and feasibility of LAAC in patients with CIEDs.
- To assess the effect of LAAC on AF burden in this population.
Main Methods:
- Retrospective analysis of patients with CIEDs undergoing LAAC from a prospective registry.
- Evaluation of procedural safety endpoints and CIED lead integrity.
- Comparison of AF burden before and after LAAC.
Main Results:
- 36 out of 586 (6%) LAAC procedures involved patients with CIEDs.
- The primary safety endpoint occurred in 3% of patients; no CIED lead dislodgement was observed.
- Mean AF burden increased from 6% to 31% post-LAAC in 20 patients (p=0.064).
Conclusions:
- LAAC is feasible and safe in patients with CIEDs.
- LAAC may be associated with an increased AF burden.
- Further prospective studies are needed to confirm these findings and explore the implications for AF management.
Abstract:
Background-Percutaneous left atrial appendage (LAA) closure (LAAC) offers a valid alternative to oral anticoagulation in patients with atrial fibrillation (AF) at high risk of bleeding. However, its impact on AF burden and device function in patients with cardiac implantable electronic devices (CIEDs) remains largely unexplored. Methods-From our prospective LAAC registry (clinicaltrial.gov-NCT04628078), which includes all consecutive LAAC procedures performed at our institution, we identified patients with a CIED and retrospectively analyzed procedural and follow-up data. The primary endpoint was defined as a composite of death, TIA/stroke, systemic or pulmonary embolism and major bleeding (BARC 3-5) within 7 days of the procedure. The secondary endpoint was CIED lead dislodgement. Additionally, AF burden was compared before and after LAAC. Results-Of the 586 LAAC procedures performed between August 2015 and January 2023, 36 patients (6%) had a CIED. The median CHA2DS2-VASC and HAS-BLED scores were 4.0 and 3.0, respectively. The primary endpoint occurred in one (3%) patient, and no patient experienced CIED lead dislodgement. AF burden data before and after LAAC were available in 20 patients. The mean AF burden increased from 6% to 31% following LAAC (p = 0.064). Conclusions-A CIED was present in 6% of LAAC procedures, and LAAC appears feasible and safe in this patient population. Larger, prospective studies are warranted to further evaluate the impact of LAAC on AF burden.
