Evidence map›Paper›PMID 38182966›Full record

SynthesisJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2024

Risk factors, clinical implications, and management of peridevice leak following left atrial appendage closure: A systematic review.

Baraa Helal, Jibran Khan, Dalia AlJayar, Mohammad Salman Khan, Mohamad S Alabdaljabar, Zain Ul Abideen Asad, Christopher V DeSimone, Abhishek Deshmukh

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
2.0field-weighted citation impact, top 14% 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

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Three-year clinical outcomes of left atrial appendage occlusion with or without ablation: insight from the RECORD study.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026
    Observational
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 at 5 institutions in 2 countries.

Baraa HelalCollege of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
Jibran KhanCollege of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
Dalia AlJayarCollege of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
Mohammad Salman KhanCollege of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
Mohamad S AlabdaljabarDepartment of Internal Medicine, Mayo Clinic, Rochester, MN, USA.ORCID http://orcid.org/0000-0002-7632-666X
Zain Ul Abideen AsadDepartment of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
Christopher V DeSimoneDepartment of Cardiovascular Medicine, 200 1St Street SW, Rochester, MN, 55905, USA.
Abhishek DeshmukhDepartment of Cardiovascular Medicine, 200 1St Street SW, Rochester, MN, 55905, USA. Deshmukh.Abhishek@mayo.edu.
Alfaisal University · SAMayo Clinic · USMayo Clinic in Arizona · USUniversity of Minnesota Rochester · USUniversity of Oklahoma Health Sciences Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLeft atrial appendage closure (LAAC) is a treatment modality for stroke prevention in patients with atrial fibrillation (AF). One of the potential complications of LAAC is a peri-device leak (PDL), which could potentially increase the risk of thromboembolism formation.

methodsThis systematic review was done according to PRISMA guidelines. Using four databases, all primary studies through April 2022 that met selection criteria were included. Outcomes of interest were studies reporting on PDL characteristics, risk factors and management.

resultsA total of 116 studies met selection criteria (97 original studies and 19 case reports/series). In the original studies (n = 30,133 patients), the weighted mean age was 72.0 ± 7.4 years (57% females) with a HAS-BLED and CHA2DS2-VASc weighted means of 2.8 ± 1.1 and 3.8 ± 1.3, respectively. The most common definition of PDL was based on size; 5 mm: major, 3-5 mm: moderate, < 1 mm minor, or trivial. Follow up time for PDL detection was 7.15 ± 9.0 months. 33% had PDL, irrespective of PDL severity/size, and only 0.9% had PDL of greater than 5 mm. The main risk factors for PDL development included lower degree of over-sizing, lower left ventricular ejection fraction, device/LAA shape mismatch, previous radiofrequency ablation, and male sex. The most common methods to screen for PDL included transesophageal echocardiogram and cardiac CT. PDL Management approaches include Amplatzer Patent Foramen Ovale occluder, Hookless ACP, Amplatzer vascular plug II, embolic coils, and detachable vascular coils; removal or replacement of the device; and left atriotomy.

conclusionFollowing LAAC, the emergence of a PDL is a significant complication to be aware of. Current evidence suggests possible risk factors that are worth assessing in-depth. Additional research is required to assess suitable candidates, timing, and strategies to managing patients with PDL.

Indexed as

Atrial AppendageAtrial FibrillationFemaleHumansLeft Atrial Appendage ClosureMalePostoperative ComplicationsRisk FactorsSeptal Occluder DeviceStrokeAtrial fibrillationLeft atrial appendagePeri-device leakWatchman

Identifiers

PMID38182966
OpenAlexW4390629923

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.