AUTHOR=Ke Jin-Yan , Jin Lu-Shen , Lin Yuan-Nan , Xu Jing , Liu Wei-Ke , Fu Jia-Yang , Li Ling , Chen Yi-Lian , Qiu Yi-Xuan , Li Yue-Chun 

TITLE=Combined atrial fibrillation ablation and left atrial appendage closure: Watchman vs. LAmbre devices

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=9

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.1011037

DOI=10.3389/fcvm.2022.1011037

ISSN=2297-055X

ABSTRACT=<sec><title>Background</title><p>Left atrial appendage closure (LAAC) combined with radiofrequency catheter ablation is an emerging one-stop hybrid procedure for non-valvular atrial fibrillation (AF). This study was performed to compare the efficacy and safety of the Watchman device vs. the LAmbre device for this combined procedure.</p></sec><sec><title>Methods</title><p>Two hundred and thirty two patients with AF who underwent the combined procedure were enrolled and divided into two subgroups depending on the device choice: the Watchman-combined group (<italic>n</italic> = 118) and the LAmbre-combined group (<italic>n</italic> = 114). The periprocedural and follow-up adverse events in both groups were documented.</p></sec><sec><title>Results</title><p>The mean CHA<sub>2</sub>DS<sub>2</sub>-VASc score and HAS-BLED score in the Watchman-combined group and LAmbre-combined group were 3.7 ± 1.5 vs. 3.8 ± 1.5 and 2.5 ± 1.1 vs. 2.3 ± 1.1, respectively (all <italic>P</italic> &gt; 0.05). Successful LAAC was achieved in all patients. The rate of major periprocedural complications and AF recurrence at 6 months post-procedure were similar between the Watchman-combined group and LAmbre-combined group (0.8 vs. 0.9%, <italic>P</italic> = 1.00; 22.0 vs. 15.8%, <italic>P</italic> = 0.23). During 2.6 ±0 .7 vs.1.6 ± 1.6 years follow-up, the rate of major clinical adverse events, including stroke and major bleeding, were comparable between the Watchman-combined group and the LAmbre-combined group (2.6 vs. 1.1% per 100 patient-years, <italic>P</italic> = 0.33). The intraprocedural peri-device leakage (PDL) rate was similar between the Watchman-combined group and the LAmbre-combined group (5.1 vs. 6.1%, <italic>P</italic> = 0.73), but the PDL rate was significantly higher at 3–6 months transesophageal echocardiography (TEE) follow-up than the intraprocedural PDL rate in both groups (21.6 vs. 5.1%; 36.6 vs. 6.1%, respectively), with a more obvious increase in minimal PDL rate in the LAmbre-combined group than the Watchman-combined group (36.6 vs. 21.6%, <italic>P</italic> &lt; 0.05).</p></sec><sec><title>Conclusion</title><p>The Watchman and LAmbre devices were comparable in efficacy and safety for the combined procedure. The minimal PDL rate at short-term TEE follow-up was higher in the LAmbre-combined group than the Watchman-combined group.</p></sec>