Cohort study
Impact of Preprocedure Imaging for Left Atrial Appendage Occlusion
- Registry-based cohort study
- multivariable logistic regression
Authors' conclusion
Preprocedure CT/CMR was associated with an increased likelihood of successful LAAO implantation; however, the magnitude of benefit appears small and it was not associated with MAE.
Study context
- Population
- Patients undergoing attempted left atrial appendage occlusion (LAAO) with WATCHMAN or WATCHMAN FLX, NCDR LAAO Registry, January 2016–June 2021
- Participants
- 114,384 procedures
- Exposure
- Preprocedure computed tomography (CT)/cardiac magnetic resonance (CMR) vs no preprocedure CT/CMR
- CT/CMRn = 20,851
- Outcome
- Implantation success (deployment and release of device), device success (released with peridevice leak <5 mm) and procedure success (also no in-hospital MAE)
Main finding
As reported in the abstract
CT/CMR vs No CT/CMROdds ratio (95% CI)
implantation success
1.08(1.00–1.17)
device success
1.10(1.04–1.16)
procedural success
1.07(1.02–1.13)
Observational data: associations, not effects.
Further findings
Use of preprocedure CT/CMR
- Preprocedure CT/CMR used
- 18.2%
Overall success rates (all procedures)
- Implantation success
- 93.4%
- Device success
- 91.2%
- Procedure success
- 89.4%
Safety
| Outcome | OR (95% CI) | |
|---|---|---|
| In-hospital MAE | 1.02 (0.92–1.12) | |
| 0.512Odds ratio (log scale) |
- In-hospital MAE — MAE overall
- 2.3%
Original publication
Impact of Preprocedure Imaging for Left Atrial Appendage Occlusion. JACC Cardiovasc Interv. Published 12 June 2023. doi:10.1016/j.jcin.2023.05.008
Summarised from the published abstract; every number is checked against it