Open AccessComparison between Amplatzer and Watchman Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillation: A Systematic Review and Meta-Analysis
Author(s) -
Jianzhong Qiao,
Bin Zhang,
Jie Wang,
Lingxin Pan,
Tieniu Cheng,
Yuan Wang,
Enlai Xiong
Publication year - 2022
Publication title -
cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.547
H-Index - 63
eISSN - 1421-9751
pISSN - 0008-6312
DOI - 10.1159/000524626
Subject(s) - medicine , atrial fibrillation , stroke (engine) , pericardial effusion , cardiology , confidence interval , odds ratio , meta analysis , cochrane library , thrombus , embolism , randomized controlled trial , tamponade , mechanical engineering , engineering
The Amplatzer and Watchman left atrial appendage closure (LAAC) devices are the two most frequently used devices for left atrial appendage closure devices worldwide. This meta-analysis aims to compare the safety and efficacy of the two devices. Methods: We searched the PubMed, EMBASE and the Cochrane Library for studies up to 6 February 2022 that compared the safety and efficacy of the Amplatzer and Watchman devices. Results: Fifteen studies including 2,150 patients in randomized controlled trials (RCTs) and 2,526 patients in observational studies were included in the meta-analysis. Amplatzer device was associated with higher rates of major procedure-related complications (odds ratio [OR]: 1.99, 95% confidence interval [CI]: 1.45–2.74, P <0.0001) and device embolization (OR: 1.99, 95% CI: 1.09–3.64, P =0.03). However, Amplatzer device had lower rates of total peridevice leak (PDL) (OR:0.48, 95% CI: 0.27–0.83, P =0.009), significant PDL (OR:0.27, 95% CI: 0.12–0.57, P =0.0007) and device-related thrombus (DRT) (OR:0.67, 95% CI: 0.48–0.95, P =0.02). No statistical differences were observed between the two devices in other safety and efficacy endpoints, such as pericardial effusion, cardiac tamponade, air embolism, vascular complications, ischemic stroke/ transient ischemic attack (TIA), hemorrhagic stroke, all-cause death, cardiovascular death and bleeding. Conclusions: Amplatzer LAAC device was associated with higher rates of major procedure-related complications, especially in device embolization. Watchman LAAC device was associated with higher rates of PDL and DRT. There were no significant differences between two devices in ischemic stroke/TIA, hemorrhagic stroke, all-cause death, cardiovascular death and bleeding.