Arrhythmias & electrophysiology
Cardiac CT Versus Transesophageal Echocardiography Following Left Atrial Appendage Closure: A Systematic Review and Meta-Analysis
Pooled result · Residual leak (left atrial appendage patency)Result — go to the resultOdds ratio 2.26 95% CI 1.48–3.44Authors' conclusion
Following LAAC, CCTA had higher odds of detecting residual leak and any PDL compared with TEE, whereas there were no significant differences in the detection of large PDL (> 5mm) and DRT between the 2 modalities. The findings of this meta-analysis should provide reassurance to patients and clinicians who prefer CCTA over TEE after LAAC. While DRT and left atrial appendage patency with visible PDL are known to be associated with thromboembolism, the clinical significance of left atrial appendage patency without visible PDL is uncertain and warrants further investigation.
Study context
- Population
- Patients who underwent both cardiac computed tomography angiography (CCTA) and transesophageal echocardiography (TEE) after percutaneous left atrial appendage closure (LAAC)
- Participants
- 1,313 patients17 cohort studies
- Comparison
- Diagnostic utility of cardiac computed tomography angiography (CCTA) compared with TEE for post-LAAC device surveillance
- Outcome
- Residual leak (left atrial appendage patency)
Pooled result
As reported in the abstract
Odds ratio
2.26
95% CI 1.48–3.44
P = 0.0002
By group
Further pooled results
| Outcome | CCTA | TEE | Odds ratio (95% CI) | P value | |
|---|---|---|---|---|---|
| Any PDLI 2 =73%; 12 studies, 870 patients; moderate certainty | 51.6% | 35.5% | 1.59 (1.01–2.51) | P = 0.04 | |
| Large PDL (>5 mm)I 2 =0%; 5 studies, 338 patients; moderate certainty | 2.8% | 0.8% | 3.12 (0.73–13.36) | P = 0.13 | |
| DRTI 2 =0%; 6 studies, 584 patients; high-certainty | 1.7% | 1.7% | 1.0 (0.41–2.42) | P = 1.0 | |
| 0.050.21520Odds ratio (log scale) |
- Device-related thrombus (DRT) — Incidence of DRT
- 1.7%
Original publication
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