Evidence map›Paper›PMID 31728875›Full record

ArticleJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2020

Comparison of echocardiographic and fluoroscopic sizing of the left atrial appendage prior to percutaneous closure.

Soroosh Kiani, Akshar Vipul Patel, Mikhael F El-Chami, Anshul M Patel, Faisal M Merchant, Stacy B Westerman, David B De Lurgio, Michael H Hoskins

Abstract read
PubMed Publisher
In one paragraph

Article in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Soroosh KianiDivision of Cardiovascular Disease, Section of Electrophysiology, Emory University School of Medicine, 101 Woodruff Circle, WMB 1013, Atlanta, GA, 30322, USA. skiani@emory.edu.ORCID http://orcid.org/0000-0001-6389-0643
Akshar Vipul PatelDivision of Cardiovascular Disease, Section of Electrophysiology, Emory University School of Medicine, 101 Woodruff Circle, WMB 1013, Atlanta, GA, 30322, USA.
Mikhael F El-ChamiDivision of Cardiovascular Disease, Section of Electrophysiology, Emory University School of Medicine, 101 Woodruff Circle, WMB 1013, Atlanta, GA, 30322, USA.ORCID http://orcid.org/0000-0003-4978-7177
Anshul M PatelDivision of Cardiovascular Disease, Section of Electrophysiology, Emory University School of Medicine, 101 Woodruff Circle, WMB 1013, Atlanta, GA, 30322, USA.
Faisal M MerchantDivision of Cardiovascular Disease, Section of Electrophysiology, Emory University School of Medicine, 101 Woodruff Circle, WMB 1013, Atlanta, GA, 30322, USA.ORCID http://orcid.org/0000-0003-0679-860X
Stacy B WestermanDivision of Cardiovascular Disease, Section of Electrophysiology, Emory University School of Medicine, 101 Woodruff Circle, WMB 1013, Atlanta, GA, 30322, USA.
David B De LurgioDivision of Cardiovascular Disease, Section of Electrophysiology, Emory University School of Medicine, 101 Woodruff Circle, WMB 1013, Atlanta, GA, 30322, USA.
Michael H HoskinsDivision of Cardiovascular Disease, Section of Electrophysiology, Emory University School of Medicine, 101 Woodruff Circle, WMB 1013, Atlanta, GA, 30322, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeSizing of the left atrial appendage (LAA) ostium prior to occlusion (LAAO) is routinely performed with transesophageal echocardiography (TEE). We sought to compare the utility of sizing via fluoroscopy to TEE for percutaneous LAAO.

methodsWe retrospectively evaluated all patients undergoing percutaneous LAAO at our institution from April 2015 through January 2018 (n = 195). We evaluated baseline characteristics, maximum measured ostium size (for both TEE and fluoroscopy), and differences in measured size to device size for both techniques.

resultsOf the total cohort, 185 (95%) had both intraoperative TEE and fluoroscopic images available for analysis and were included in the final analysis. The mean age was 74 years and 64% were male. Hypertension was present in 89%, diabetes in 30%, and stroke in 32% of patients. The mean ejection fraction was 51%. The most common LAA morphology was "wind sock" (52%). Measured ostial diameter on fluoroscopy was larger compared with TEE (2.04 ± 3.43 mm larger on fluoroscopy, p < 0.001). Ostium diameter on TEE was more closely correlated to the size of the device implanted compared with fluoroscopy (0.76 vs. 0.61, p = 0.001).

conclusionsFluoroscopy results in larger estimated LAA ostium diameter compared with TEE. Despite this, TEE was more strongly correlated to operator choice in device sizing, which may reflect practice patterns. Because compression of the ostium on the device is necessary for long-term procedural success, under-sizing may lead to a higher rate of leaks. Prospective evaluation of the utility of routine fluoroscopic sizing compared with TEE is warranted.

Indexed as

Atrial AppendageAtrial FibrillationCardiac CatheterizationEchocardiographyEchocardiography, TransesophagealFluoroscopyHumansInfant, NewbornMaleRetrospective StudiesTreatment OutcomeAtrial fibrillationEchocardiographyLeft atrial appendage occlusionStroke

Identifiers

PMID31728875

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.