Clinical outcomes of Watchman vs. Amplatzer occluders for left atrial appendage closure (WATCH at LAAC). Issue 6 (31st January 2020)

• Record Type: Journal Article
• Authors: Kleinecke, Caroline; Yu, Jiangtao; Neef, Philip; Buffle, Eric; de Marchi, Stefano; Fuerholz, Monika; Nietlispach, Fabian; Valgimigli, Marco; Streit, Samuel R; Fankhauser, Mate; Duenninger, Erich; Windecker, Stephan; Meier, Bernhard; Gloekler, Steffen
• Is Part Of: Europace. Volume 22:Issue 6(2020)
• Page Start: 916
• Page End: 923
• Publication Date: 2020-01-31
• Subjects: Atrial fibrillation -- Stroke prevention -- Left atrial appendage closure -- Watchman -- Amplatzer -- Anticoagulation; Arrhythmia -- Treatment -- Periodicals; Cardiac pacing -- Periodicals; Catheter ablation -- Periodicals; Heart -- Physiology -- Periodicals; Electrophysiology -- Periodicals; 617.4120645
• DOI: 10.1093/europace/euaa001
• Languages: English
• ISSNs: 1099-5129

Abstract

Abstract: Aims: This study compares clinical outcomes of Watchman vs. Amplatzer devices for left atrial appendage closure (LAAC). Methods and results: Of two real-world registries, the Watchman registry Lichtenfels, Germany, and the Amplatzer registry Bern-Zurich, Switzerland, 303 and 333 consecutive patients, respectively, were included. After a 1:1 propensity score matching, 266 vs. 266 patients were compared by use of the predefined primary efficacy endpoint of stroke, systemic embolism and cardiovascular/unexplained death, the primary safety endpoint of major peri-procedural complications and major bleeding events at follow-up, and the combined hazard endpoint, a composite of all above-mentioned hazards. Mean age was 75.3 ± 7.8 (Watchman) vs. 75.1 ± 9.9 (Amplatzer) years, CHA2 DS2 -VASc score 4.5 ± 1.7 vs. 4.5 ± 1.5, and HAS-BLED score 3.2 ± 1.0 vs. 3.2 ± 1.0. At a mean follow-up of 2.4 ± 1.3 vs. 2.5 ± 1.5 years and 1.322 patient-years, the primary endpoints of efficacy [40/646, 6.2% [Watchman] vs. 43/676, 6.4% [Amplatzer]; hazard ratio (HR), 1.02; 95% confidence interval (CI), 0.66–1.58; P = 0.92] and safety (33/646, 5.1% vs. 30/676, 4.4%; HR, 0.57; 95% CI, 0.29–1.11; P = 0.10), as well as the combined hazard endpoint (69/646, 10.7% vs. 66/676, 9.8%; HR, 0.80; 95% CI, 0.55–1.12; P = 0.26) were similar for both groups. Conclusion: This study suggests comparable efficacy and safety of the Watchman and Amplatzer devices.