Infection Rate and Outcomes of Watchman Devices: Results from a Single
Center 14-Year Experience
Abstract
Background: Left atrial appendage occlusion with the Watchman device is
an alternative strategy for stroke risk reduction in patients with
non-valvular atrial fibrillation. There are rare case reports of
Watchman associated infection. Currently, there is no formal study that
evaluated the incidence and outcomes of Watchman-related infections.
Methods: All patients who underwent Watchman implantation over a 14 year
study period (July 2004 through December 2018) comprised our cohort.
Baseline characteristics, procedural data, and post-implantation events
were identified. Primary study outcomes included Watchman related
infection, other cardiovascular device related infection, bacteremia,
and mortality. Results: A total of 181 patients with an average age of
75, and a median CHA2DS2-VASc Score of 4 (interquartile range 2) and a
median HAS-BLED Score of 3 (interquartile range 1), were included for
analysis. A total of 534.7 patient years of follow up was accrued with
an average of 2.9 years per patient. The most common indications for
implantation included gastrointestinal bleeding (56 patients; 30.9%)
and intracerebral bleeding (51 patients; 28.2%). During follow up, 38
patients (21%) died. Six developed evidence of bacteremia. Only one
developed an implantable cardioverter defibrillator (ICD) infection that
required complete system extraction. None of the cohort developed
Watchman-related device infection during the study period. Conclusion:
In a single center study spanning a 14 year period, we report no
Watchman-related devices infections. This is despite the presence of
patients with bacteremia, as well as an ICD infection requiring
extraction. These data suggest that Watchman devices are extremely
unlikely to become infected.