Introduction
Left atrial appendage closure (LAAC) is increasingly utilized to
mitigate stroke risk in patients unable to tolerate anticoagulation.
Serious complications from LAAC with the WATCHMAN™ device are rare.
According to the NCDR registry, major in-hospital adverse events occur
in only 2.16% of cases and 1.39% of these events were due to
pericardial effusion requiring intervention (1). To date, there have
been no reported risk factors for pericardial effusion development
following LAAC. In the PINNACLE FLX trial, there were no acute
pericardial effusions requiring drainage within the first 7 days from
WATCHMAN FLX™ device implant; however, 3 patients required
pericardiocentesis between 7 and 45 days (2). We present a case series
of two patients with hyperdynamic left atrial appendages who developed
pericardial effusions following WATCHMAN FLX™ implantation.