Arrhythmias & electrophysiology
Incidence and predictors of persistent left atrial appendage patency and its subtypes after percutaneous closure: a pre-specified analysis of the SWISS-APERO trial
Authors' conclusion
In a prospective multi-centre cohort of clinically indicated LAAC, approximately two-thirds of 45-day PAs, especially those related to large side-gap leaks with bigger LAA-device off-axis angle, persisted at 13 months, whereas new-onset PA occurred in roughly 1 in every 10 patients.
Study context
- Population
- Patients undergoing percutaneous left atrial appendage (LAA) closure (Amulet or Watchman/FLX), 8 European centres158 (71.5%) in matched cardiac computed tomography angiography (CCTA) analysis
- Participants
- 221 patients
- Primary endpoint
- Persistent or new-onset LAA patency at CCTA (presence, type and predictors)
- Follow-up
- 13 months
Methodological detailspre-specified analysis, multicentre, imaging core-lab
- Pre-specified analysis
- Multicentre
- Imaging core-lab
Primary result
As reported in the abstract
Residual LAA patency decreased from 45 days to 13 months
66.4 to 50.6%
45-day patent appendages resolved at 13 months
30.5%
Further findings
Persistence of side-gap leaks at 45 days · 13 months
- Side-gap leaks: Patent appendages (PA) subtype with highest likelihood of persistence
- 86%
'ARA LAAO' score ≥ 2 at 45-day CCTA predicting leak persistence (side-gap leak proximal area >37.7 mm², radial diameter >3 mm, LAA-device angle >39.4°) · 13 months
- Sensitivity
- 94.1%
- Specificity
- 70%
Original publication
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