Watchman FLX versus Amplatzer amulet for percutaneous left atrial appendage occlusion: A systematic review and meta-analysis.

BACKGROUND

The comparative safety and efficacy of Watchman FLX (Boston Scientific, Marlborough, MA, USA) and Amplatzer Amulet (Abbott, Abbott Park, IL, USA) devices for left atrial appendage occlusion (LAAO) remain unclear.

OBJECTIVE

To compare Watchman FLX and Amplatzer Amulet devices for LAAO.

METHODS

We systematically searched PubMed, Embase, and Cochrane Library for studies comparing Watchman FLX versus Amulet in patients with atrial fibrillation (AF) undergoing percutaneous LAAO. We applied a random-effects model to pool risk ratios (RR) with corresponding 95 % confidence intervals (CI) for binary endpoints.

RESULTS

We included five studies comprising 1316 patients with AF undergoing LAAO for high bleeding risk. A total of 629 (47.8 %) patients underwent LAAO with Watchman FLX. Amulet was associated with lower rates of stroke or transient ischemic attack (TIA) (RR 2.31; 95 % CI 1.02-5.25; p = 0.04; I2 = 0 %), but no differences were observed in terms of peridevice leak (RR 1.57; 95 % CI 0.86-2.89; p = 0.14; I2 = 0 %) between Watchman and Amulet devices. Additionally, no differences were found in terms of device-related thrombus (RR 2.01; 95 % CI 0.87-4.68; p = 0.10; I2 = 0 %), or pericardial effusion (RR 1.00; 95 % CI 0.17-5.96; p = 1.00; I2 = 59.7 %) between both groups.

CONCLUSION

This meta-analysis indicates a lower risk of stroke or TIA with Amulet compared to Watchman FLX.