Evidence map›Paper›PMID 33438184›Full record

ArticleCardiology journal2021

Impact of conscious sedation and general anesthesia on periprocedural outcomes in Watchman left atrial appendage closure.

Caroline Kleinecke, Wasim Allakkis, Eric Buffle, Xiao-Xia Liu, Yamen Mohrez, Steffen Gloekler, Johannes Brachmann, Steffen Schnupp, Stephan Achenbach, Jiangtao Yu

Open access · goldAbstract read
In one paragraph

Article in Cardiology journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
3.5field-weighted citation impact, top 6% of its field
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

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
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

10 authors at 5 institutions in 3 countries.

Caroline KleineckeDepartment of Cardiology, REGIOMED Klinikum Lichtenfels, Lichtenfels, Germany. carolinekleinecke@web.de.
Wasim AllakkisDepartment of Cardiology, REGIOMED Klinikum Coburg, Coburg, Germany.
Eric BuffleDepartment of Cardiology, University Hospital Bern, Bern, Switzerland.
Xiao-Xia LiuDepartment of Cardiology, REGIOMED Klinikum Coburg, Coburg, Germany.
Yamen MohrezDepartment of Cardiology, REGIOMED Klinikum Coburg, Coburg, Germany.
Steffen GloeklerDepartment of Cardiology, University Hospital Bern, Bern, Switzerland.
Johannes BrachmannDepartment of Cardiology, REGIOMED Klinikum Coburg, Coburg, Germany.
Steffen SchnuppDepartment of Cardiology, REGIOMED Klinikum Coburg, Coburg, Germany.
Stephan AchenbachDepartment of Cardiology, Friedrich-Alexander University Erlangen-Nuernberg, Erlangen, Germany.
Jiangtao YuDepartment of Cardiology, REGIOMED Klinikum Lichtenfels, Lichtenfels, Germany.
Klinikum Coburg · DEUniversity Hospital of Bern · CHFriedrich-Alexander-Universität Erlangen-Nürnberg · DEKatholisches Klinikum Koblenz · DESana Klinikum Lichtenberg · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTranscatheter left atrial appendage closure (LAAC) is performed either in conscious sedation (CS) or general anesthesia (GA), and limited data exist regarding clinical outcomes for the two approaches. The aim of the study was to analyze the effect of CS versus GA on acute outcomes in a large patient cohort undergoing LAAC with a Watchman occluder.

methodsA cohort of 521 consecutive patients underwent LAAC with Watchman occluders at two centers (REGIOMED hospitals, Germany) between 2012 and 2018. One site performed 303 consecutive LAAC procedures in GA, and the other site performed 218 consecutive procedures in CS. The safety endpoint was a composite of major periprocedural complications and postoperative pneumonia. The efficacy endpoint was defined as device success.

resultsAfter a 1:1 propensity score matching, 196 (CS) vs. 115 (GA) patients could be compared. In 5 (2.6%) cases CS was converted to GA. The primary safety endpoint (3.5% [CS] vs. 7.0% [GA], p = 0.18) and its components (major periprocedural complications: 2.5% vs. 3.5%, p = 0.73; postoperative pneumonia: 2.6% vs. 4.3%, p = 0.51) did not differ between the groups. Also, device success was comparable (96.9% vs. 93.9%, p = 0.24).

conclusionsIn patients undergoing LAAC with the Watchman device, conscious sedation and general anesthesia showed comparable device success rates and safety outcomes. The type of anesthesia for LAAC may therefore be tailored to patient comorbidities, operator experience, and hospital logistics.

Indexed as

Atrial AppendageAtrial FibrillationCardiac Surgical ProceduresStrokeAnesthesia, GeneralHumansProcedural SedationPropensity ScoreTreatment Outcomeatrial fibrillationconscious sedationgeneral anesthesialeft atrial appendage closureWatchman

Identifiers

PMID33438184
PMCPMC8277000
OpenAlexW3115914833

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.