Author + information
- Received April 8, 2014
- Revision received May 1, 2014
- Accepted May 8, 2014
- Published online November 1, 2014.
- Jacqueline Saw, MD∗ ( and )
- Mathieu Lempereur, MD
- Division of Cardiology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada
- ↵∗Reprint requests and correspondence:
Dr. Jacqueline Saw, Division of Cardiology, Vancouver General Hospital, University of British Columbia, 2775 Laurel Street, Level 9, Vancouver, British Columbia V5Z1M9, Canada.
Percutaneous left atrial appendage closure technology for stroke prevention in patients with atrial fibrillation has significantly advanced in the past 2 decades. Several devices are under clinical investigation, and a few have already received Conformité Européene (CE)-mark approval and are available in many countries. The WATCHMAN device (Boston Scientific, Natick, Massachusetts) has the most supportive data and is under evaluation by the U.S. Food and Drug Administration for warfarin-eligible patients. The Amplatzer Cardiac Plug (St. Jude Medical, Plymouth, Minnesota) has a large real-world experience over the past 5 years, and a randomized trial comparing Amplatzer Cardiac Plug with the WATCHMAN device is anticipated in the near future. The Lariat procedure (SentreHEART Inc., Redwood City, California) has also gained interest lately, but early studies were concerning for high rates of serious pericardial effusion and major bleeding. The current real-world experience predominantly involves patients who are not long-term anticoagulation candidates or who are perceived to have high bleeding risks. This pattern of practice is expected to change when the U.S. Food and Drug Administration approves the WATCHMAN device for warfarin-eligible patients. This paper reviews in depth the procedural techniques, safety, and outcomes of the current leading devices.
Dr. Saw is a proctor and consultant for St. Jude Medical and Boston Scientific. Dr. Lempereur has reported that he has no relationships relevant to the contents of this paper to disclose.
- Received April 8, 2014.
- Revision received May 1, 2014.
- Accepted May 8, 2014.
- American College of Cardiology Foundation
- Indications for Percutaneous LAA Closure
- Devices for Percutaneous LAA Occlusion
- Implantation Techniques for WATCHMAN and ACP
- Implantation Techniques for Lariat
- Clinical Trials Evaluating Safety and Efficacy of LAA Occlusion
- Complications With Percutaneous LAA Closure and Management
- Selection and Comparison of Leading LAA Devices