Percutaneous Left Atrial Appendage Closure: Review of Anatomy, Imaging, and Outcomes

Purpose of review Percutaneous left atrial appendage closure (LAAC) with WATCHMAN (Boston Scientific Inc.) has emerged as a viable non-pharmacological alternative for stroke prevention in several randomized clinical trials in high-risk AF patients with relative and absolute contraindications to anticoagulation. Several considerations include the proper selection of the patients, type of device, the antithrombotic therapy, and their duration post-procedurally. Recent findings The WATCHMAN device and the recently FDA-approved Abbott Amplatzer Amulet for stroke prevention in AF have shown satisfactory outcomes in stroke prevention. Multiple trials have studied the WATCHMAN device in detail in terms of efficacy and safety. However, there are no current papers that include all these studies and examine them together. In this manuscript, we take an in-depth look at these trials. This manuscript reviews essential factors in the LAAC device's selection process and evaluates the current studies that have assessed their efficacy coupled with various antithrombotic therapies post-implantation. Based on these trials, it can be demonstrated that the WATCHMAN device is an efficacious device for stroke prevention in patients who are not candidates for anticoagulation, and the recently approved Amulet device has shown comparable outcomes.