Arrhythmias & electrophysiology
Incidence and temporal evolution of delayed peridevice leak after left atrial appendage closure
Authors' conclusion
Despite design improvements, LAAC with Watchman FLX demonstrates a significant incidence of PDL with meaningful clinical implications. Regardless of initial size, most leaks regressed over time.
Study context
- Population
- Patients undergoing left atrial appendage closure (LAAC) with Watchman FLX with no peridevice leak (PDL) at implantationcompleted imaging
- Participants
- 355 patients
- Outcome
- Incidence of new PDL at initial imaging
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
New PDL
139
39%
Leak size, mean ± SD
3.2 ± 1.4 mm
Leak size, median (IQR; range)
3.0 mm
2.0–4.0 mm; 1.0–9.0 mm
Observational data: associations, not effects.
Secondary outcomes
Composite (continued OAC, device-related thrombus, stroke/TIA, major bleeding, need for PDL closure) · longest follow-up
P < 0.001
Predictors of PDL
- Multiple deployment attempts and larger device size were positive predictors; increased contrast volume was a negative predictor
Temporal evolution of leak size (surveillance imaging, 43 [31%] of PDL patients) · 46 days to 189 days
- Leak size at 46 days (IQR 44-51 days)
- 3.7 ± 1.8 mm
- Leak size at 189 days (IQR 158-285 days)
- 1.7 ± 2.0 mm
- Regressed
- 33 (77%)
- Stable
- 4 (9%)
- Progressed
- 6 (14%)
- P < .001
Original publication
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