Zhu Ming-Zhen, Song Hao, Song Guang-Min, Bai Xiao
Department of Cardiovascular Surgery, Qilu Hospital of Shandong University, Jinan, China.
Pacing Clin Electrophysiol. 2022 Oct;45(10):1237-1247. doi: 10.1111/pace.14576. Epub 2022 Sep 1.
Left atrial appendage occlusion (LAAO) is an alternative to oral anticoagulation (OAC) to decrease the risk of stroke in patients with nonvalvular atrial fibrillation (NVAF); however, certain complications remain a concern. Amplatzer Amulet and Watchman are the two most popular used devices for preventing stroke in patients with NVAF. We assessed the safety and efficacy of LAAO using the Amplatzer Amulet and Watchman.
A meta-analysis was conducted to compare the safety and efficacy outcomes associated with the use of the Amplatzer Amulet and Watchman 2.5. The Newcastle-Ottawa Scale has been utilized to assess the quality of study.
The meta-analysis includes seven studies involving 2926 patients (1418 patients with an amulet and 1508 with a Watchman 2.5). Generally, adverse event rates for both systems were minimal. No significant differences between the two devices were found in safety (pericardial effusion, device embolization, and cardiac tamponade) or efficacy outcomes (death, TIA, stroke, major/minor bleeding, device leak, and thromboembolic events).
The data suggest LAAO is a safe procedure, regardless of which device was used. LAAO devices generally have low complication rates. Outcomes were comparable between the two groups with no significant differences in their safety or efficacy.
左心耳封堵术（LAAO）是一种用于降低非瓣膜性心房颤动（NVAF）患者中风风险的替代口服抗凝药（OAC）的方法；然而，某些并发症仍然令人担忧。Amplatzer Amulet和Watchman是用于预防NVAF患者中风的两种最常用的装置。我们评估了使用Amplatzer Amulet和Watchman进行LAAO的安全性和有效性。
进行荟萃分析以比较使用Amplatzer Amulet和Watchman 2.5相关的安全性和有效性结果。采用纽卡斯尔-渥太华量表评估研究质量。
荟萃分析纳入了7项研究，涉及2926例患者（1418例使用Amulet，1508例使用Watchman 2.5）。总体而言，两种系统的不良事件发生率都很低。在安全性（心包积液、装置栓塞和心脏压塞）或有效性结果（死亡、短暂性脑缺血发作、中风、严重/轻微出血、装置渗漏和血栓栓塞事件）方面，两种装置之间未发现显著差异。
数据表明，无论使用哪种装置，LAAO都是一种安全的手术。LAAO装置的并发症发生率通常较低。两组结果具有可比性，在安全性或有效性方面无显著差异。
