Arrhythmias & electrophysiology
Zero-fluoroscopy left atrial appendage occlusion with the Watchman FLX device
Authors' conclusion
In this proof-of-concept study, a routine approach of transesophageal echocardiography-guided, zero-fluoroscopy LAAO with the Watchman FLX device was safe and feasible.
Study context
- Population
- Patients undergoing left atrial appendage occlusion (LAAO) with the Watchman FLX device under general anaesthesia and TEE guidance, without fluoroscopy
- Participants
- 239 consecutive patients
- Outcome
- Key safety endpoint: death, ischemic stroke, systemic embolism, open heart surgery or major endovascular intervention; key effectiveness outcome: peridevice leak (<3 mm, 3-5 mm, >5 mm)
- Follow-up
- Up to discharge or 7 days after the procedure, whichever came later
Methodological detailsconsecutive patients, proof-of-concept
- Consecutive patients
- Proof-of-concept
Main finding
As reported in the abstract
Key safety endpoint
1 patient
Peridevice leak >3 mm
0
Successful zero-fluoroscopy LAAO
205
85.7%
Bailout fluoroscopy required
34
14.3%
Observational data: associations, not effects.
Further findings
Peridevice leak <3 mm · 45 days
- Peridevice leak <3 mm
- 16 of 218 patients (7.3%)
Safety
Device-related thrombus · 45 days
- Device-related thrombus
- 1 patient (0.4%)
Original publication
Zero-fluoroscopy left atrial appendage occlusion with the Watchman FLX device. Heart Rhythm. Published 19 December 2025. doi:10.
Summarised from the published abstract; every number is checked against it