Incidence, impact and predictors of residual device patency after left atrial appendage closure with the LACbes device
The residual device patency (RDP) after left atrial appendage closure (LAAC) with the LACbes device has not been specifically explored in atrial fibrillation (AF) patients. This study aims to explore the incidence, impact and predictors of RDP detected by cardiac computed tomography angiography (CCT...
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| Veröffentlicht in: | International journal of cardiology 2024-02, Vol.397, p.131640-131640, Article 131640 |
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| container_title | International journal of cardiology |
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| creator | Yao, Peng-Cheng Fei, Zhen-Tao Chen, Mu Mo, Bin-Feng Zhang, Rui Yang, Yu-Li Sun, Jian Wang, Qun-Shan Li, Yi-Gang |
| description | The residual device patency (RDP) after left atrial appendage closure (LAAC) with the LACbes device has not been specifically explored in atrial fibrillation (AF) patients. This study aims to explore the incidence, impact and predictors of RDP detected by cardiac computed tomography angiography (CCTA) post LAAC.
AF patients implanted with the LACbes device were prospectively enrolled. CCTA device surveillance was performed at 3 months post-procedure. Major adverse events (MAEs), including stroke/transient ischemic attack, major bleeding and all-cause death, were evaluated.
Among 141 patients with CCTA surveillance, 56 (39.7%) showed no visible leak and 85 (60.3%) showed RDP. During the median follow-up of 443 [232, 706] days, the presence of RDP was not associated with an increased risk of MAEs (adjusted hazard ratio [HR]: 4.07, 95% confidence interval [CI]: 0.49-34.24, p = 0.196), while peri-device leak (PDL) at the lobe was associated with heightened risks of MAEs (adjusted HR: 6.85, 95% CI: 1.62-28.89, p = 0.009). In patients with PDL at the lobe, antiplatelet after 6 months (HR: 0.20, 95% CI: 0.05-0.91, p = 0.038) was independent protective predictor of MAEs. Besides, current smoking (odds ratio [OR]: 7.52, 95% CI: 2.68-21.08, p |
| doi_str_mv | 10.1016/j.ijcard.2023.131640 |
| format | Article |
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AF patients implanted with the LACbes device were prospectively enrolled. CCTA device surveillance was performed at 3 months post-procedure. Major adverse events (MAEs), including stroke/transient ischemic attack, major bleeding and all-cause death, were evaluated.
Among 141 patients with CCTA surveillance, 56 (39.7%) showed no visible leak and 85 (60.3%) showed RDP. During the median follow-up of 443 [232, 706] days, the presence of RDP was not associated with an increased risk of MAEs (adjusted hazard ratio [HR]: 4.07, 95% confidence interval [CI]: 0.49-34.24, p = 0.196), while peri-device leak (PDL) at the lobe was associated with heightened risks of MAEs (adjusted HR: 6.85, 95% CI: 1.62-28.89, p = 0.009). In patients with PDL at the lobe, antiplatelet after 6 months (HR: 0.20, 95% CI: 0.05-0.91, p = 0.038) was independent protective predictor of MAEs. Besides, current smoking (odds ratio [OR]: 7.52, 95% CI: 2.68-21.08, p < 0.001) and maximum diameter of LAA orifice (OR: 1.16, 95% CI: 1.00-1.34, p = 0.048) were independent predictors of PDL at the lobe.
Presence of PDL at the device lobe detected by CCTA at 3-month post LAAC with LACbes is associated with unfavorable prognosis in AF patients.
ClinicalTrials.gov Identifier: NCT03788941.</description><identifier>ISSN: 0167-5273</identifier><identifier>EISSN: 1874-1754</identifier><identifier>DOI: 10.1016/j.ijcard.2023.131640</identifier><identifier>PMID: 38065326</identifier><language>eng</language><publisher>Netherlands</publisher><subject>Atrial Appendage - diagnostic imaging ; Atrial Appendage - surgery ; Atrial Fibrillation - diagnostic imaging ; Atrial Fibrillation - surgery ; Cardiac Catheterization ; Echocardiography, Transesophageal ; Humans ; Incidence ; Left Atrial Appendage Closure ; Prostheses and Implants - adverse effects ; Stroke - epidemiology ; Treatment Outcome</subject><ispartof>International journal of cardiology, 2024-02, Vol.397, p.131640-131640, Article 131640</ispartof><rights>Copyright © 2023 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c256t-b1841cbc8202c18b3bf6854bd8482ae3311f982bacbd19e3d9f88e545ffc46163</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38065326$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yao, Peng-Cheng</creatorcontrib><creatorcontrib>Fei, Zhen-Tao</creatorcontrib><creatorcontrib>Chen, Mu</creatorcontrib><creatorcontrib>Mo, Bin-Feng</creatorcontrib><creatorcontrib>Zhang, Rui</creatorcontrib><creatorcontrib>Yang, Yu-Li</creatorcontrib><creatorcontrib>Sun, Jian</creatorcontrib><creatorcontrib>Wang, Qun-Shan</creatorcontrib><creatorcontrib>Li, Yi-Gang</creatorcontrib><title>Incidence, impact and predictors of residual device patency after left atrial appendage closure with the LACbes device</title><title>International journal of cardiology</title><addtitle>Int J Cardiol</addtitle><description>The residual device patency (RDP) after left atrial appendage closure (LAAC) with the LACbes device has not been specifically explored in atrial fibrillation (AF) patients. This study aims to explore the incidence, impact and predictors of RDP detected by cardiac computed tomography angiography (CCTA) post LAAC.
AF patients implanted with the LACbes device were prospectively enrolled. CCTA device surveillance was performed at 3 months post-procedure. Major adverse events (MAEs), including stroke/transient ischemic attack, major bleeding and all-cause death, were evaluated.
Among 141 patients with CCTA surveillance, 56 (39.7%) showed no visible leak and 85 (60.3%) showed RDP. During the median follow-up of 443 [232, 706] days, the presence of RDP was not associated with an increased risk of MAEs (adjusted hazard ratio [HR]: 4.07, 95% confidence interval [CI]: 0.49-34.24, p = 0.196), while peri-device leak (PDL) at the lobe was associated with heightened risks of MAEs (adjusted HR: 6.85, 95% CI: 1.62-28.89, p = 0.009). In patients with PDL at the lobe, antiplatelet after 6 months (HR: 0.20, 95% CI: 0.05-0.91, p = 0.038) was independent protective predictor of MAEs. Besides, current smoking (odds ratio [OR]: 7.52, 95% CI: 2.68-21.08, p < 0.001) and maximum diameter of LAA orifice (OR: 1.16, 95% CI: 1.00-1.34, p = 0.048) were independent predictors of PDL at the lobe.
Presence of PDL at the device lobe detected by CCTA at 3-month post LAAC with LACbes is associated with unfavorable prognosis in AF patients.
ClinicalTrials.gov Identifier: NCT03788941.</description><subject>Atrial Appendage - diagnostic imaging</subject><subject>Atrial Appendage - surgery</subject><subject>Atrial Fibrillation - diagnostic imaging</subject><subject>Atrial Fibrillation - surgery</subject><subject>Cardiac Catheterization</subject><subject>Echocardiography, Transesophageal</subject><subject>Humans</subject><subject>Incidence</subject><subject>Left Atrial Appendage Closure</subject><subject>Prostheses and Implants - adverse effects</subject><subject>Stroke - epidemiology</subject><subject>Treatment Outcome</subject><issn>0167-5273</issn><issn>1874-1754</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kMtu2zAQAIkiRe06-YMi4DGHyOVLFHU0jKQ1YKCX9kzwsaxpyJJCUin895Vht6e9zOxiB6EvlKwpofLrcR2PziS_ZoTxNeVUCvIBLalqREWbWtyh5Yw1Vc0avkCfcz4SQkTbqk9owRWRNWdyid53vYseegfPOJ5G4wo2vcdjAh9dGVLGQ8AJcvST6bCH9-gAj6bMxhmbUCDhDsIslRRnwIwj9N78Buy6IU8J8J9YDrgcAO83Wwv5tuIefQymy_Bwmyv06_Xl5_Z7tf_xbbfd7CvHalkqS5Wgzjo1_-iostwGqWphvRKKGeCc0tAqZo2znrbAfRuUglrUITghqeQr9HTdO6bhbYJc9ClmB11nehimrFlLWCtV015QcUVdGnJOEPSY4smks6ZEX4rro74W15fi-lp81h5vFyZ7Av9f-peY_wXsun-7</recordid><startdate>20240215</startdate><enddate>20240215</enddate><creator>Yao, Peng-Cheng</creator><creator>Fei, Zhen-Tao</creator><creator>Chen, Mu</creator><creator>Mo, Bin-Feng</creator><creator>Zhang, Rui</creator><creator>Yang, Yu-Li</creator><creator>Sun, Jian</creator><creator>Wang, Qun-Shan</creator><creator>Li, Yi-Gang</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20240215</creationdate><title>Incidence, impact and predictors of residual device patency after left atrial appendage closure with the LACbes device</title><author>Yao, Peng-Cheng ; Fei, Zhen-Tao ; Chen, Mu ; Mo, Bin-Feng ; Zhang, Rui ; Yang, Yu-Li ; Sun, Jian ; Wang, Qun-Shan ; Li, Yi-Gang</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c256t-b1841cbc8202c18b3bf6854bd8482ae3311f982bacbd19e3d9f88e545ffc46163</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Atrial Appendage - diagnostic imaging</topic><topic>Atrial Appendage - surgery</topic><topic>Atrial Fibrillation - diagnostic imaging</topic><topic>Atrial Fibrillation - surgery</topic><topic>Cardiac Catheterization</topic><topic>Echocardiography, Transesophageal</topic><topic>Humans</topic><topic>Incidence</topic><topic>Left Atrial Appendage Closure</topic><topic>Prostheses and Implants - adverse effects</topic><topic>Stroke - epidemiology</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yao, Peng-Cheng</creatorcontrib><creatorcontrib>Fei, Zhen-Tao</creatorcontrib><creatorcontrib>Chen, Mu</creatorcontrib><creatorcontrib>Mo, Bin-Feng</creatorcontrib><creatorcontrib>Zhang, Rui</creatorcontrib><creatorcontrib>Yang, Yu-Li</creatorcontrib><creatorcontrib>Sun, Jian</creatorcontrib><creatorcontrib>Wang, Qun-Shan</creatorcontrib><creatorcontrib>Li, Yi-Gang</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yao, Peng-Cheng</au><au>Fei, Zhen-Tao</au><au>Chen, Mu</au><au>Mo, Bin-Feng</au><au>Zhang, Rui</au><au>Yang, Yu-Li</au><au>Sun, Jian</au><au>Wang, Qun-Shan</au><au>Li, Yi-Gang</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Incidence, impact and predictors of residual device patency after left atrial appendage closure with the LACbes device</atitle><jtitle>International journal of cardiology</jtitle><addtitle>Int J Cardiol</addtitle><date>2024-02-15</date><risdate>2024</risdate><volume>397</volume><spage>131640</spage><epage>131640</epage><pages>131640-131640</pages><artnum>131640</artnum><issn>0167-5273</issn><eissn>1874-1754</eissn><abstract>The residual device patency (RDP) after left atrial appendage closure (LAAC) with the LACbes device has not been specifically explored in atrial fibrillation (AF) patients. This study aims to explore the incidence, impact and predictors of RDP detected by cardiac computed tomography angiography (CCTA) post LAAC.
AF patients implanted with the LACbes device were prospectively enrolled. CCTA device surveillance was performed at 3 months post-procedure. Major adverse events (MAEs), including stroke/transient ischemic attack, major bleeding and all-cause death, were evaluated.
Among 141 patients with CCTA surveillance, 56 (39.7%) showed no visible leak and 85 (60.3%) showed RDP. During the median follow-up of 443 [232, 706] days, the presence of RDP was not associated with an increased risk of MAEs (adjusted hazard ratio [HR]: 4.07, 95% confidence interval [CI]: 0.49-34.24, p = 0.196), while peri-device leak (PDL) at the lobe was associated with heightened risks of MAEs (adjusted HR: 6.85, 95% CI: 1.62-28.89, p = 0.009). In patients with PDL at the lobe, antiplatelet after 6 months (HR: 0.20, 95% CI: 0.05-0.91, p = 0.038) was independent protective predictor of MAEs. Besides, current smoking (odds ratio [OR]: 7.52, 95% CI: 2.68-21.08, p < 0.001) and maximum diameter of LAA orifice (OR: 1.16, 95% CI: 1.00-1.34, p = 0.048) were independent predictors of PDL at the lobe.
Presence of PDL at the device lobe detected by CCTA at 3-month post LAAC with LACbes is associated with unfavorable prognosis in AF patients.
ClinicalTrials.gov Identifier: NCT03788941.</abstract><cop>Netherlands</cop><pmid>38065326</pmid><doi>10.1016/j.ijcard.2023.131640</doi><tpages>1</tpages></addata></record> |
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| subjects | Atrial Appendage - diagnostic imaging Atrial Appendage - surgery Atrial Fibrillation - diagnostic imaging Atrial Fibrillation - surgery Cardiac Catheterization Echocardiography, Transesophageal Humans Incidence Left Atrial Appendage Closure Prostheses and Implants - adverse effects Stroke - epidemiology Treatment Outcome |
| title | Incidence, impact and predictors of residual device patency after left atrial appendage closure with the LACbes device |
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