The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

WATCHMAN Versus ACP or Amulet – From the German Left Atrial Appendage Occluder Registry LAARGE

DOI: 10.4244/EIJ-D-19-01027

1. CardioVascular Center CVC, Frankfurt, Germany, Germany
2. I. Medizinische Klinik, Universitätsmedizin Mannheim, Germany
3. Heart Center, Segeberger Kliniken GmbH, Bad Segeberg, Germany
4. Städtisches Klinikum Lüneburg, Lüneburg, Germany
5. I. Medizinische Klinik B, Klinikum der Stadt Ludwigshafen, Ludwigshafen, Germany
6. Innere Medizin III, Universitätsklinikum Heidelberg, Germany
7. Stiftung Institut für Herzinfarktforschung (IHF), Ludwigshafen, Germany
8. Klinik für Kardiologie, Pneumologie und Intern. Intensivmed., Klinikum Neuperlach, München, Germany
9. Peter Osypka Heart Center Munich, München, Germany
10. Medizinische Klinik II, Klinikum Coburg, Coburg, Germany
11. Anglia Ruskin University, Chelmsford, UK, United Kingdom
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Aims: Several left atrial appendage (LAA) closure systems are available and due to differences in device design results of specific occluders derived from trials cannot be simply generalized to all devices. The present analysis sought to assess two contemporary LAA closure devices in clinical practice.

Methods and results: The work represents a non-randomized sub-analysis of the prospective, multicenter, Left-Atrium-Appendage Occluder Register - GErmany (LAARGE) registry. The WATCHMAN (group 1) and the Amplatzer Cardiac Plug (ACP) or Amulet occluder (group 2) were assessed. A total of 641 patients at 38 centers were enrolled. Of them, 278 (43%) and 340 (53%) patients received the WATCHMAN and ACP/Amulet occluder, respectively. High technical success was achieved with a slight difference between the groups (96% in group 1 vs. 99% in group 2; p=0.007). Procedural safety did not differ (98% in group 1 vs. 97% in group 2; p=0.55). The Kaplan Meier estimated 1-year composite of death or stroke was 12.0% and 12.9%, respectively (p=0.79).

Conclusions: Both the WATCHMAN and the ACP/Amulet occluder provide excellent procedural results with comparable implantation success and no differences with respect to procedural safety and long-term effectiveness.

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