Arrhythmias & electrophysiology
Impact of Spontaneous Echo Contrast on Clinical Outcomes After Left Atrial Appendage Closure
Authors' conclusion
Patients with greater SEC grade displayed a higher incidence of thromboembolic events and DRT, and combined SEC grade and AF type independently predicted these events.
Study context
- Population
- Consecutive patients undergoing left atrial appendage closure
- Participants
- 1,276 patients
- Exposure
- Spontaneous echo contrast (SEC) grades on preprocedural TEE
- SEC 0+n = 595reference
- SEC 1/2+n = 509
- SEC 3/4+n = 172
- Outcome
- Ischemic stroke/TIA/systemic embolism
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
SEC 3/4+ vs SEC 0+: P = 0.009 · SEC 3/4+ vs SEC 1/2+: P = 0.047
Observational data: associations, not effects.
Further findings
Device-related thrombus (DRT) — SEC 1/2+ vs SEC 0+
P < 0.001
SEC 3/4+ with nonparoxysmal atrial fibrillation (AF) (combined SEC grade and AF type)
| Adjusted HR (95% CI) | P value | ||
|---|---|---|---|
| SEC 3/4+ with nonparoxysmal AFThromboembolic events | 2.52 (1.22–5.20) | P = 0.013 | |
| SEC 3/4+ with nonparoxysmal AFDRT | 2.89 (1.50–5.60) | P = 0.003 | |
| 0.20.5125Adjusted hazard ratio (log scale) |
| Outcome | P value |
|---|---|
| Device-related thrombus (DRT)SEC 3/4+ vs SEC 0+ | P < 0.001 |
Original publication
Impact of Spontaneous Echo Contrast on Clinical Outcomes After Left Atrial Appendage Closure. JACC Clin Electrophysiol. Published 12 November 2025. doi:10.
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