Multipurpose radiofrequency wire system improves procedural workflow compared with mechanical needle for left atrial appendage closure.

Percutaneous left atrial appendage closure (LAAC) is a rapidly emerging therapy for atrial fibrillation patients not suitable for anticoagulation. The study compared procedural time and adverse events between mechanical Brockenbrough needle and the VersaCross radiofrequency system for WATCHMAN implantation. All patients undergoing LAAC at Vancouver General Hospital were prospectively enrolled. Procedural workflow, times, and complications were compared in 20 patients: 10 using VersaCross radiofrequency system and 10 using Brockenbrough needle. Transseptal puncture success was 100%. The radiofrequency wire reduced total procedural time by 27% (21.5 vs 29.5 minutes; P=.008) and fluoroscopy and contrast use without increasing complications. One ischemic stroke occurred during 360-day follow-up unrelated to the device. The multipurpose radiofrequency system streamlines LAAC workflow and is a safe, efficient alternative to mechanical puncture. Larger randomized trials are warranted to confirm these benefits.