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Updated: Jan 8, 2026
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The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
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Zero-fluoroscopy left atrial appendage occlusion with the Watchman FLX device
Tarun Chakravarty1, Sabah Skaf1, Uttam Singh1
1Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
Heart Rhythm
|December 21, 2025
Summary
This study shows that transesophageal echocardiography-guided, zero-fluoroscopy left atrial appendage occlusion (LAAO) with the Watchman FLX device is safe and feasible. This approach offers a promising alternative to conventional fluoroscopic guidance for LAAO procedures.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Imaging
Background:
- Percutaneous left atrial appendage occlusion (LAAO) traditionally relies on fluoroscopic guidance.
- Minimizing radiation exposure is a key goal in cardiovascular interventions.
Purpose of the Study:
- To assess the feasibility and safety of performing LAAO using the Watchman FLX device without fluoroscopy.
- To evaluate an alternative guidance method for LAAO procedures.
Main Methods:
- Procedures were performed under general anesthesia using transesophageal echocardiography (TEE) for guidance.
- Key safety endpoint included major adverse events up to 7 days post-procedure.
- Effectiveness was assessed by peri-device leak size.
Main Results:
- 239 patients underwent attempted zero-fluoroscopy LAAO with Watchman FLX; 205 (85.7%) were successful.
- One patient experienced an in-hospital death unrelated to the procedure itself.
- No patients had significant peri-device leaks (>3mm); minor leaks (<3mm) were observed in 7.3%.
Conclusions:
- TEE-guided, zero-fluoroscopy LAAO with the Watchman FLX device is a safe and feasible approach.
- This technique represents a viable alternative to fluoroscopy for LAAO.
