ArticleJACC. Asia2026
Effect of Device Size on Outcomes Following Left Atrial Appendage Closure in Borderline-Sized Anatomy.
Article in JACC. Asia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
4 citing papers in PubMed.
- Outcomes of Different Device Sizing Strategies Using the Newer-Generation WATCHMAN Devices for Closure of Borderline-Sized Left Atrial Appendage.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2026Article
- Advances of Fully Biodegradable Poly-p-Dioxanone and Polylactic Acid-Based Polymers as Left Atrial Appendage Closure Devices.Macromolecular bioscience · 2026Review
- Device Size or Residual Leak?: Stroke Risk in Borderline Left Atrial Appendage Anatomy.JACC. Asia · 2026Article
- Bigger May Be Better Indeed?: Navigating Device Sizing in Left Atrial Appendage Closure.JACC. Asia · 2026Article
Corrections and comments
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Authors and funding
24 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSelecting the optimal WATCHMAN FLX (a second-generation left atrial appendage [LAA] closure device) size for a borderline-sized LAA, for which 2 device sizes are acceptable, remains challenging.
objectivesThe aim of this study was to evaluate how device size affects procedural and clinical outcomes in borderline-sized LAAs undergoing LAA closure.
methodsFrom the Japanese multicenter TERMINATOR (Transcatheter Modification of Left Atrial Appendage by Obliteration with Device in Patients With NVAF) registry, 1,190 patients who underwent LAA closure with the second-generation device between May 2021 and September 2023 were reviewed. Of these, 757 with borderline-sized LAAs were included and categorized into large (n = 390) and small (n = 367) device groups. The median follow-up duration was 274 days (Q1-Q3: 100-368 days). Outcomes included peridevice leak (PDL), all-cause mortality, ischemic cerebrovascular accident or systemic embolism, major bleeding, and device-related thrombus.
resultsPDL occurred less frequently in the large device group compared with the small device group (1.54% [6 of 390] vs 4.90% [18/367]; P = 0.015). Ischemic cerebrovascular accident or systemic embolism was lower in the large device group (8.4% [95% CI: 1.8%-34.1%] vs 10.5% [95% CI: 3.6%-28.4%]; P = 0.036). No significant difference was observed in all-cause mortality (15.2% [95% CI: 6.0%-35.7%] vs 12.3% [95% CI: 4.6%-30.6%]; P = 0.288), major bleeding (4.5% [95% CI: 2.6%-7.7%] vs 15.7% [95% CI: 4.3%-48.7%]; P = 0.570), or device-related thrombus (8.6% [95% CI: 3.2%-22.2%] vs 3.2% [95% CI: 1.6%-6.4%]; P = 0.603).
conclusionsIn borderline-sized LAAs, the larger device was associated with fewer PDLs and ischemic events without increased procedural risk.
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