Abstract
The WATCHMAN® device will remain the landmark advance which demonstrated in randomised control trials that a local left atrial appendage-based therapy could provide effective thromboembolic stroke prevention for patients with atrial fibrillation. This chapter gives a detailed overview of the technology and its historical development, including the evidence base to date. Step-by-step procedural technique and potential complications are discussed.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Abbreviations
- Ao V:
-
Aortic valve
- CT:
-
Computed tomography
- LAA:
-
Left atrial appendage
- LPV:
-
Left pulmonary vein
- Mi V:
-
Mitral valve
- RPV:
-
Right pulmonary vein
- TEE:
-
Transesophageal echocardiography
References
Holmes DR, Reddy VY, Turi ZG, Doshi SK, Sievert H, Buchbinder M, Mullin CM, Sick P. Percutaneous closure of the left atrial appendage versus warfarin therapy for prevention of stroke in patients with atrial fibrillation: a randomised non-inferiority trial. Lancet. 2009;374:534–42.
Sick PB, Schuler G, Hauptmann KE, Grube E, Yakubov S, Turi ZG, Mishkel G, Almany S, Holmes DR. Initial worldwide experience with the WATCHMAN left atrial appendage system for stroke prevention in atrial fibrillation. J Am Coll Cardiol. 2007;49:1490–5.
Reddy VY, Doshi SK, Sievert H, Buchbinder M, Neuzil P, Huber K, Halperin JL, Holmes DR. Percutaneous left atrial appendage closure for stroke prophylaxis in patients with atrial fibrillation 2.3-year follow-up of the PROTECT AF (Watchman left atrial appendage system for embolic protection in patients with atrial fibrillation) trial. Circulation. 2013;127:720–9.
Reddy VY, Doshi SK, Sievert H, et al. Long term results of PROTECT AF: the mortality effects of left atrial appendage closure versus warfarin for stroke prophylaxis in AF. In: Proceedings of heart rhythm scientific meeting, Denver; 8–11 May 2013.
Reddy VY, Holmes DR, Doshi SK, Neuzil P, Kar S. Safety of percutaneous left atrial appendage closure. Results from the watchman left atrial appendage system for embolic protection in patients with AF (PROTECT AF) clinical trial and the continued access registry. Circulation. 2011;123:417–24.
Holmes DR, Doshi S, Kar S, et al. Results of randomized trial of LAA closure vs. warfarin for stroke/thromboembolic prevention in patients with non-valvular atrial fibrillation (PREVAIL). In: Proceedings of China interventional therapeutics conference, Shanghai; 20–23 March 2013.
Connolly SJ, Ezekowitz MD, Yusuf S, Eikelboom J, Oldgren J, Parekh A, Pogue J, Reilly PA, Themeles E, Varrone J, Wang S, Alings M, Xavier D, Zhu J, Diaz R, Lewis BS, Darius H, Diener HC, Joyner CD, Wallentin L. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med. 2009;361:1139–51.
Patel MR, Mahaffey KW, Garg J, Pan G, Singer DE, Hacke W, Breithardt G, Halperin JL, Hankey GJ, Piccini JP, Becker RC, Nessel CC, Paolini JF, Berkowitz SD, Fox KA, Califf RM. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med. 2011;365:883–91.
Granger CB, Alexander JH, McMurray JJ, Lopes RD, Hylek EM, Hanna M, Al-Khalidi HR, Ansell J, Atar D, Avezum A, Bahit MC, Diaz R, Easton JD, Ezekowitz JA, Flaker G, Garcia D, Geraldes M, Gersh BJ, Golitsyn S, Goto S, Hermosillo AG, Hohnloser SH, Horowitz J, Mohan P, Jansky P, Lewis BS, Lopez-Sendon JL, Pais P, Parkhomenko A, Verheugt FW, Zhu J, Wallentin L. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2011;365:981–92.
Reddy VY, Mobius-Winkler S, Miller MA, Neuzil P, Schuler G, Wiebe J, Sick P, Sievert H. Left atrial appendage closure with the watchman device in patients with a contraindication for oral anticoagulation. The ASAP study (ASA plavix feasibility study with watchman left atrial appendage closure technology). J Am Coll Cardiol. 2013;61:2551–6.
Sepahpour A, Ng MK, Storey P, McGuire MA. Death from pulmonary artery erosion complicating implantation of percutaneous left atrial appendage occlusion device. Heart Rhythm. 2013;10:1810–1.
Meincke F, Schmidt-Salzmann M, Kreidel F, Kuck KH, Bergmann MW. New technical and anticoagulation aspects for left atrial appendage closure using the WATCHMAN® device in patients not taking warfarin. EuroIntervention. 2013;9:463–8.
Maleki K, Mohammadi R, Hart D, Cotiga D, Farhat N, Steinberg JS. Intracardiac ultrasound detection of thrombus on transseptal sheath: incidence, treatment, and prevention. J Cardiovasc Electrophysiol. 2005;16:561–5.
Ren JF, Marchlinski FE, Callans DJ, Gerstenfeld EP, Dixit S, Lin D, Nayak HM, Hsia HH. Increased intensity of anticoagulation may reduce risk of thrombus during atrial fibrillation ablation procedures in patients with spontaneous echo contrast. J Cardiovasc Electrophysiol. 2005;16:474–7.
Chun J, Bordignon S, Urban V, Perrotta L, Dugo D, Furnkranz A, Nowak B, Schmidt B. Left atrial appendage closure followed by 6 weeks of antithrombotic therapy: a prospective single-center experience. Heart Rhythm. 2013;10:1792–9.
Ostermayer SH, Reisman M, Kramer PH, Matthews RV, Gray WA, Block PC, Omran H, Bartorelli AL, Della Bella P, Di Mario C, Pappone C, Casale PN, Moses JW, Poppas A, Williams DO, Meier B, Skanes A, Teirstein PS, Lesh MD, Nakai T, Bayard Y, Billinger K, Trepels T, Krumsdorf U, Sievert H. Percutaneous left atrial appendage transcatheter occlusion (PLAATO system) to prevent stroke in high-risk patients with non-rheumatic atrial fibrillation: results from the international multi-center feasibility trials. J Am Coll Cardiol. 2005;46:9–14.
Viles-Gonzalez JF, Kar S, Douglas P, Dukkipati S, Feldman T, Horton R, Holmes D, Reddy VY. The clinical impact of incomplete left atrial appendage closure with the Watchman Device in patients with atrial fibrillation: a PROTECT AF (Percutaneous closure of the left atrial appendage versus warfarin therapy for prevention of stroke in patients with atrial fibrillation) substudy. J Am Coll Cardiol. 2012;59:923–9.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2016 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Phillips, K.P., Kar, S. (2016). WATCHMAN Device. In: Saw, J., Kar, S., Price, M. (eds) Left Atrial Appendage Closure. Contemporary Cardiology. Humana Press, Cham. https://doi.org/10.1007/978-3-319-16280-5_10
Download citation
DOI: https://doi.org/10.1007/978-3-319-16280-5_10
Publisher Name: Humana Press, Cham
Print ISBN: 978-3-319-16279-9
Online ISBN: 978-3-319-16280-5
eBook Packages: MedicineMedicine (R0)