AnchorMan versus Watchman 2.5: a randomised comparison in left atrial appendage closure

The recent online publication of the CHAMPION-AF trial in the New England Journal of Medicine marks another milestone in the evolution of left atrial appendage closure (LAAC), further consolidating its role as an alternative to oral anticoagulation in selected patients with atrial fibrillation.1 As the field matures, the key question is no longer whether LAAC works but how outcomes can be optimised through device selection and design. In this context, randomised comparisons between devices are critically needed, yet remain limited.

In this issue of EuroIntervention, Wang et al address this need with the SAFE-PROTECT trial, comparing the novel AnchorMan device (MicroPort) with the Watchman 2.5 (Boston Scientific) in a multicentre randomised study of 216 patients.2 A comparison with Watchman FLX or FLX Pro (both Boston Scientific) would be preferable, rather than with the Watchman 2.5, which is now considered a legacy device. The trial met its primary endpoint, demonstrating the non-inferiority of AnchorMan for a composite of ischaemic and haemorrhagic stroke, systemic embolism, and cardiovascular or unexplained death at 12 months. However, these findings should be interpreted as hypothesis-generating,...