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Percutaneous left atrial appendage closure is not ready for routine clinical use

Published:October 10, 2017DOI:https://doi.org/10.1016/j.hrthm.2017.10.007
      In this review, we challenge the use of left atrial appendage (LAA) occlusion with Watchman for stroke prevention in patients with atrial fibrillation on the basis of 1) unreliable and divergent results of the regulatory trials; 2) a strong inferiority signal from the Prospective Randomized Evaluation of the Watchman LAA Closure Device In Patients With Atrial Fibrillation Versus Long Term Warfarin Therapy (PREVAIL) trial; 3) an uncertain pathophysiological basis for LAA occlusion; and 4) insufficient data to support Watchman in patients ineligible for anticoagulation.

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