Left Atrial Appendage Closure with Watchman vs Amulet Devices: Similarities and Differences

Curr Cardiol Rep. 2023 Sep;25(9):909-915. doi: 10.1007/s11886-023-01913-7. Epub 2023 Aug 16.

Abstract

Purpose of review: Left atrial appendage closure (LAAC) has shown to be non-inferior to oral anticoagulation (OAC) for non-valvular atrial fibrillation (AF). LAAC is now becoming a leading method for stroke prophylaxis in patients who have atrial fibrillation and are unable to tolerate OAC. There are currently two FDA-approved endocardial closure devices, namely, the Watchman FLX and Amplatzer Amulet.

Recent findings: Current data highlights that both devices offer similar efficacy and safety for LAAC. While the two devices differ in terms of intraprocedural complication rates, they offer similar short- to long-term outcomes in regard to peri-device leaks, device-related thrombosis, and mortality. With similar risk and safety profiles, both devices are indicated for patients who are unable to tolerate OAC. Newer clinical studies are directed to establish the efficacy of both devices as the primary method for stroke prevention in AF as an alternate to OAC.

Keywords: Amulet device; Device-related thrombosis; Left atrial appendage closure; Oral anticoagulation; Peri-device leaks; Watchman FLX.

Publication types

  • Review

MeSH terms

  • Anticoagulants / therapeutic use
  • Atrial Appendage* / surgery
  • Atrial Fibrillation* / complications
  • Atrial Fibrillation* / drug therapy
  • Atrial Fibrillation* / surgery
  • Cardiac Surgical Procedures* / methods
  • Humans
  • Stroke* / drug therapy
  • Stroke* / etiology
  • Stroke* / prevention & control
  • Treatment Outcome

Substances

  • Anticoagulants