The AMULET Left Atrial Appendage Closure Device: Technical Considerations and Procedural Approach

The Amplatzer Amulet Left Atrial Appendage (LAA) Occluder is a percutaneous device designed to lower the risk of thrombus embolization from the LAA in patients with nonvalvular atrial fibrillation (AF). We will take an depth look at the Amulet LAAO device design. It offers significant improvements compared to its predecessor ACP and provides another option for LAAO to the Watchman FLX. The Amulet device has advantages in certain patient populations and LAA anatomies. Although a similar implant procedure to Watchman, the two-stage disc and lobe deployment, longer stabilizing wires, complex sizing grid, and more proximal location offer unique challenges to the operators who will implant these devices. In this chapter, there are comparative anatomy, clinical indications, and unique considerations for the device. Moreover, there is a detailed discussion on optimal procedural steps for device implantation and complication management.