• Vikash Jaiswal, Song Peng Ang, Abhigan Babu Shrestha, Zarghoona Wajid, Evbayekha Osas Endurance, Fathima Shehnaz Ayoobkhan, Shazia Khan, Vamsi Garimellla, Helen Huang, Mohammed Ghanim, David Song, Prachi Sharma, M Chadi Alraies, and Monodeep Biswas.
• Department of Cardiovascular Research, Larkin Community Hospital, South Miami, FL.
• Medicine (Baltimore). 2023 Jun 30; 102 (26): e34185e34185.

BackgroundThe Amplatzer Amulet (AA) and Watchman devices (WD) are the 2 most frequently used devices for percutaneous LAA closure globally.ObjectiveTo evaluate the safety and clinical outcomes associated with these 2 devices in patients undergoing percutaneous LAA closure.MethodWe systematically searched all electronic databases from inception until February 21, 2023. The primary endpoint was procedure related complications. Secondary endpoints were device related thrombus, stroke, cardiovascular mortality, peri device leak, systemic embolism, and all-cause mortality.ResultsA total of 3 randomized clinical trials with 2150 patients were included in this meta-analysis. The mean age was 75 and 76 years in the Amplatzer group and in the Watchman group, respectively. The odds of procedure-related complications (OR, 1.80 [95% CI: 1.21-2.67], P < .001) were significantly higher among patients with AA compared to the WD. However, the odds of all-cause mortality (OR, 0.75 (95% CI: 0.49-1.16), P = .20), stroke (OR, 0.79 [95% CI: 0.47-1.34], P = .39), systemic/pulmonary embolism (OR, 1.34 [95% CI: 0.30-6.04], P = .70), and major bleeding (OR, 1.10 [95% CI: 0.83-1.48], P = .50) were comparable between the two devices. The odds of device related thrombus (OR, 0.72 [95% CI: 0.46-1.14], P = .17) was comparable between both the group of patients, however the incidence of peri device leak was significantly lower in AA group (OR, 0.41 [95% CI: 0.26-0.66], P < .001) compared with WD group of patients.ConclusionThe AA was not superior to the Watchman device in terms of safety and efficacy. However, the Amulet occluder was associated with a higher incidence of procedure-related complications, and lower peri device leak.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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