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Feasibility and safety of left atrial appendage occlusion guided by procedural fluoroscopy only: A pilot study
Author(s) -
Wang Juntao,
Rong Bing,
Zhang Kai,
Chen Tongshuai,
Lin Mingjie,
Han Wenqiang,
Sha Rina,
Wang Shoudong,
Feng Xuan,
Zhong Jingquan
Publication year - 2021
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.14292
Subject(s) - medicine , fluoroscopy , left atrial appendage occlusion , atrial fibrillation , occlusion , thrombosis , surgery , radiology , cardiology , warfarin
Abstract Background Left atrial appendage occlusion (LAAO) is usually performed via the guidance of procedural transesophageal echocardiography (TEE) companied by general anesthesia (GA). Objective To investigate the feasibility and safety of LAAO guided by procedural fluoroscopy only. Methods The patients eligible for LAAO were enrolled into the current study and received implantation of either Watchman device or LAmbre device. The procedure was carried out with procedural fluoroscopy only and no companied GA; the position, shape, and leakage of the device were assessed by contrast angiography. TEE was performed after 3‐month follow‐up to evaluate the thrombosis, and leakage of device. Results Ninety‐seven patients with atrial fibrillation (AF) with either Watchman device (n = 49) or LAmbre device (n = 48) were consecutively enrolled. Watchman device group was of lower CHA 2 DS 2 ‐VASc and HAS‐BLED scores compared with LAmbre device groups ( p < .05); the two groups had similar distributions of other baseline characteristics ( p > .05), including procedural success rate (98.0% vs. 97.9%), mean procedure time, mean fluoroscopy time, total radiation dose, contrast medium dose, percentage of peri‐device leakage. Pericardial effusions requiring intervention occurred in two of the Watchman group. TEE follow‐up found no patient with residual leakage ≥5 mm at 3 months and no device related thrombosis (DRT). During the 22.0 ± 11.1 months follow‐up, two patients experienced ischemic stroke. Conclusions LAAO with the procedural imaging of fluoroscopy only exhibited the promising results of efficacy and safety. A prospective randomized multicenter study would be required to verify the observations in this study.