Real-world experience comparing two common left atrial appendage closure devices

Abstract

Background: The interventional left atrial appendage closure (LAAC) is a guideline-conform alternative to oral anticoagulation (OAC) in non-valvular atrial fibrillation patients with OAC ineligibility. It was aimed to directly compare two contemporary devices in a real-world patient population. Methods: LAAC was conducted in two centres between 2010 and 2014 as well as between 2014 and 2017, respectively, in a standard fashion based on the specific manufacturer's recommendations. Baseline characteristics, procedural data and event rates during intra-hospital and 6months follow-up were registered in a retrospective approach, and analysed in device-related groups. Results: A total of 189 patients presented for LAAC device implantation. Baseline characteristics were mostly evenly distributed. In 148 patients, a Watchman™ device (Boston Scientific, Natick, MA, USA) was successfully implanted, an Amplatzer™ Amulet™ (St. Jude Medical, St. Paul, MN, USA) in 34 patients (96.1 and 97.1%, respectively; p=1.00). Major access site bleedings were more frequent in the Amplatzer™ Amulet™ group (8.9 versus 1.4%; p=0.046). No intra-hospital thromboembolic event was present. During 6months follow-up, peri-device leaks >5mm and thromboembolic events were uncommon (each p=n.s.). Conclusions: While procedural success was equally high with both contemporary devices, complications during follow-up were rare, and evenly distributed.