Arrhythmias & electrophysiology
Reproducibility of cardiac computed tomography classifications of hypoattenuated thickening and peridevice leak following left atrial appendage closure
Authors' conclusion
Despite only minimal training of one rater, overall high levels of inter- and intra-rater agreement and reliability were observed across the chosen algorithms for interpretation of HAT and PDL following Watchman FLX LAAC.
Study context
- Population
- Post-LAAC cardiac computed tomography (CT) scans after Watchman FLX left atrial appendage closure
- Participants
- 100 CT scans
- Exposure
- Experienced vs novice rater; repeated readings by each rater
- Outcome
- Inter- and intra-rater agreement and reliability of CT interpretation of hypoattenuated thickening (HAT) and peridevice leak (PDL)
Methodological detailsmulticentre, blinded raters, Each scan evaluated twice by each rater within the same cardiac phase
- Multicentre
- Blinded raters
- Each scan evaluated twice by each rater within the same cardiac phase
Main finding
As reported in the abstract
Inter- and intra-rater agreement and reliability, overall HAT and PDL categories
- Overall hypoattenuated thickening (HAT) and peridevice leak (PDL) categories: substantial agreement (kappa)
- ≥0.61
- Overall HAT and PDL categories: reliability (Kendall's tau-b)
- ≥ 0.75
- High-grade HAT: highest agreement within HAT (kappa)
- ≥0.78
- Distal patency: highest agreement within PDL (kappa)
- ≥0.85
- Height of proximal screw hub cove: least reliable HAT assessment, inter- and intra-rater (ICC)
- < 0.75
Observational data: associations, not effects.
Original publication
Reproducibility of cardiac computed tomography classifications of hypoattenuated thickening and peridevice leak following left atrial appendage closure. Eur Heart J Cardiovasc Imaging. Published 3 September 2024. doi:10.
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