Arrhythmias & electrophysiology
Impact of Preprocedural Computed Tomography on Left Atrial Appendage Closure Success: A Swiss-Apero Trial Subanalysis
Authors' conclusion
In a prospective multicenter cohort of clinically indicated echocardiography-guided LAACs, unblinding of the first operators to preprocedural CCTA images was independently associated with a higher rate of both short- and long-term procedural success.
Study context
- Population
- Patients undergoing echocardiography-guided percutaneous left atrial appendage closure (LAAC) (Amulet or Watchman 2.5/FLX) preceded by CCTALAACs preceded by CCTA
- Participants
- 219 patients
- Comparison
- Operators unblinded vs blinded to preprocedural CCTA in echocardiography-guided LAAC
- CCTA unblindedn = 92
- CCTA blindedn = 127reference
- Primary endpoint
- Procedural success: complete left atrial appendage occlusion without procedure-related complications
- Follow-up
- End of LAAC (short-term) and 45-day (long-term)
Methodological detailsinvestigator-initiated, multicentre, 8 European centres
- Investigator-initiated
- Multicentre
- 8 European centres
Primary result
As reported in the abstract
Procedural success (complete LAA occlusion without procedural-related complications)
CCTA unblinded
- Short-term procedural success
- 93.5%
- Long-term procedural success
- 83.7%
CCTA blinded
- Short-term procedural success
- 81.1%
- Long-term procedural success
- 72.4%
Short-term procedural success
CCTA unblinded93.5%
CCTA blinded81.1%
Long-term procedural success
CCTA unblinded83.7%
CCTA blinded72.4%
CCTA unblinded vs CCTA blindedEstimate (95% CI)P value
Unadjusted P = 0.009; end of LAAC
adjusted OR for short-term procedural success 2.76(1.05–7.29)
P = 0.040Unadjusted P = 0.050; 45-day follow-up
adjusted OR for long-term procedural success 2.12(1.03–4.35)
P = 0.041Original publication
Impact of Preprocedural Computed Tomography on Left Atrial Appendage Closure Success: A Swiss-Apero Trial Subanalysis. JACC Cardiovasc Interv. Published 3 May 2023. doi:10.
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