The Watchman and LAmbre devices demonstrated comparable efficacy and safety for the combined procedure, with similar rates of major clinical adverse events (2.6 vs. 1.1% per 100 patient-years, P=0.33).
Cohort (n=232)
No
Does the Watchman device compared to the LAmbre device improve efficacy and safety in patients with non-valvular AF undergoing combined LAAC and ablation?
Absolute Event Rate: 2.6% vs 1.1%
p-value: p=0.33
Background Left atrial appendage closure (LAAC) combined with radiofrequency catheter ablation is an emerging one-stop hybrid procedure for non-valvular atrial fibrillation (AF). This study was performed to compare the efficacy and safety of the Watchman device vs. the LAmbre device for this combined procedure. Methods Two hundred and thirty two patients with AF who underwent the combined procedure were enrolled and divided into two subgroups depending on the device choice: the Watchman-combined group ( n = 118) and the LAmbre-combined group ( n = 114). The periprocedural and follow-up adverse events in both groups were documented. Results The mean CHA 2 DS 2 -VASc score and HAS-BLED score in the Watchman-combined group and LAmbre-combined group were 3.7 ± 1.5 vs. 3.8 ± 1.5 and 2.5 ± 1.1 vs. 2.3 ± 1.1, respectively (all P 0.05). Successful LAAC was achieved in all patients. The rate of major periprocedural complications and AF recurrence at 6 months post-procedure were similar between the Watchman-combined group and LAmbre-combined group (0.8 vs. 0.9%, P = 1.00; 22.0 vs. 15.8%, P = 0.23). During 2.6 ±0 .7 vs.1.6 ± 1.6 years follow-up, the rate of major clinical adverse events, including stroke and major bleeding, were comparable between the Watchman-combined group and the LAmbre-combined group (2.6 vs. 1.1% per 100 patient-years, P = 0.33). The intraprocedural peri-device leakage (PDL) rate was similar between the Watchman-combined group and the LAmbre-combined group (5.1 vs. 6.1%, P = 0.73), but the PDL rate was significantly higher at 3–6 months transesophageal echocardiography (TEE) follow-up than the intraprocedural PDL rate in both groups (21.6 vs. 5.1%; 36.6 vs. 6.1%, respectively), with a more obvious increase in minimal PDL rate in the LAmbre-combined group than the Watchman-combined group (36.6 vs. 21.6%, P 0.05). Conclusion The Watchman and LAmbre devices were comparable in efficacy and safety for the combined procedure. The minimal PDL rate at short-term TEE follow-up was higher in the LAmbre-combined group than the Watchman-combined group.
Ke et al. (Wed,) conducted a cohort in Non-valvular atrial fibrillation (n=232). Watchman device (with radiofrequency catheter ablation) vs. LAmbre device (with radiofrequency catheter ablation) was evaluated on Major clinical adverse events (per 100 patient-years) (p=0.33). The Watchman and LAmbre devices demonstrated comparable efficacy and safety for the combined procedure, with similar rates of major clinical adverse events (2.6 vs. 1.1% per 100 patient-years, P=0.33).