Arrhythmias & electrophysiology

Outcomes of Left Atrial Appendage Patency After Device Closure Detected by Cardiac Computed Tomography (CT): A Meta-Analysis

JACC Cardiovasc ImagingPublished Systematic review and meta-analysis

Authors' conclusion

LAA patency and PDL identified by CT may be associated with an increased risk of thromboembolism.

Study context

Population
Patients after left atrial appendage occlusion (LAAO) with follow-up cardiac CT
Participants
2,036 patients · 17 studies
Comparison
Residual left atrial appendage (LAA) patency or PDL on cardiac CT vs no residual leak after LAAO
Outcome
Thromboembolism
Follow-up
During
Methodological detailsBayesian meta-analysis
  • Bayesian meta-analysis

Pooled result

As reported in the abstract

Thromboembolism
Each group vs no leakPooled odds ratio (95% CI)
LAA patency28 (95% CI: 3-68) additional events per 1,000 patients
1.87(1.08–3.24)
PDLnot significant
1.50(0.85–2.65)

Further pooled results

OutcomeMedian OR (95% CrI)
Thromboembolism, Bayesian analysis (noninformative prior) — LAA patency vs No leak · mean logOR 0.59 (95% CrI 0.06-1.15) · CrI1.87 (1.06–3.14)
Thromboembolism, Bayesian analysis (noninformative prior) — PDL vs No leak · mean logOR 0.38 (95% CrI −0.22 to 0.95) · CrI1.53 (0.80–2.59)
OutcomeMean ARD (95% CrI)
Thromboembolism, Bayesian analysis (noninformative prior) — LAA patency vs No leak · posterior probability of ARD >0%: 98.5% · CrI2.8% (0.2%–6.8%)
Thromboembolism, Bayesian analysis (noninformative prior) — PDL vs No leak · posterior probability of ARD >0%: 89.8% · CrI1.9% (−0.7% to 5.4%)

Original publication

Outcomes of Left Atrial Appendage Patency After Device Closure Detected by Cardiac CT: A Meta-Analysis. JACC Cardiovasc Imaging. Published 8 September 2025. doi:10.1016/j.jcmg.2025.07.018

Summarised from the published abstract; every number is checked against it

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