Arrhythmias & electrophysiology
Watchman FLX versus Watchman 2.5 for left atrial appendage closure: a propensity score-matched analysis
Authors' conclusion
In a large dual-centre cohort of consecutive, successful LAAC procedures using two iterations of the Watchman device, the Watchman FLX was associated with significantly lower rates of both DRT and PDL compared to the Watchman 2.5.
Study context
- Population
- Consecutive successful LAAC procedures with Watchman device implantation at two high-volume centres, July 2018–January 2023matched cohort
- Participants
- 1,128 vs 1,128
- Exposure
- Watchman FLX vs Watchman 2.5
- Watchman FLXn = 1,128
- Watchman 2.5n = 1,128reference
- Outcome
- DRT and PDL on transoesophageal echocardiography (TOE), and stroke rate
- Follow-up
- Longest available
Methodological detailspropensity-score matched, dual-centre, consecutive patients
- Propensity-score matched
- Dual-centre
- Consecutive patients
Main finding
As reported in the abstract
mean 2.3 months
Watchman FLX
- Device-related thrombus (DRT)
- 0.2%
- Peridevice leak (PDL)
- 21.0%
Watchman 2.5
- DRT
- 3.1%
- PDL
- 30.6%
Device-related thrombus (DRT)
Watchman FLX0.2%
Watchman 2.53.1%
Peridevice leak (PDL)
Watchman FLX21.0%
Watchman 2.530.6%
Watchman FLX vs Watchman 2.5Hazard ratio (95% CI)P value
DRT
0.35(0.21–0.38)
P = 0.017PDL
0.68(0.59–0.77)
P = 0.031Observational data: associations, not effects.
Further findings
| Outcome | Watchman FLX | Watchman 2.5 | HR (95% CI) | P value | |
|---|---|---|---|---|---|
| Stroke · mean 1.6 yearsNumerically lower | 3.4% | 5.1% | 0.56 (0.15–1.69) | P = 0.078 | |
| 0.10.31310Hazard ratio (log scale) |
Original publication
Watchman FLX versus Watchman 2.5 for left atrial appendage closure: a propensity score-matched analysis. EuroIntervention. Published 15 December 2025. doi:10.
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