Percutaneous left atrial appendage closure: a review of the WATCHMAN clinical trial experience

The burden of atrial fibrillation (AF) and associated risk of stroke continues to grow with an aging population. The mainstay of stroke prevention in AF is oral anticoagulation. However, a large number of patients cannot, or choose not to take oral anticoagulation due to associated bleeding. Left atrial appendage (LAA) closure is an alternative strategy of stroke prevention in the setting of AF for patients with reasons to avoid chronic oral anticoagulants. The most rigorously studied means of LAA closure is the WATCHMAN device. The WATCHMAN device is a nitinol framed intracardiac device, placed in the LAA via a transseptal approach. We review the option of WATCHMAN LAA closure including the evidence behind its use and future directions for LAA closure research.