Evidence map›Paper›PMID 41903032›Full record

ReviewJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2026

The additive value of preprocedural cardiac computed tomography angiography (CCTA) planning in percutaneous left atrial appendage occlusion: a systematic review and meta-analysis.

Elsayed Balbaa, Mohamed Saad Rakab, Ahmed Farid Gadelmawla, Ahmed Mazen Amin, Abdelrahman M Tawfik, Abdelrahman Elgendy, Alaa R Al-Ihribat, Mustafa Turkmani, Obieda Altobaishat, Mohamed S Elgendy and 2 more

Abstract readReview
PubMed Publisher
In one paragraph

Review in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2026. 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
–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

2 citing papers in PubMed.

  1. Review
  2. 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

12 authors.

Elsayed Balbaa *Faculty of Medicine, Alexandria University, Alexandria, Egypt. elsayedbalbaa.med@gmail.com.
Mohamed Saad Rakab *Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Ahmed Farid GadelmawlaFaculty of Medicine, Menoufia University, Menoufia, Egypt.
Ahmed Mazen AminFaculty of Medicine, Mansoura University, Mansoura, Egypt.
Abdelrahman M TawfikFaculty of Medicine, Alexandria University, Alexandria, Egypt.
Abdelrahman ElgendyFaculty of Medicine, Mansoura University, Mansoura, Egypt.
Alaa R Al-IhribatFaculty of Medicine, Palestine Polytechnic University, Hebron, Palestine.
Mustafa TurkmaniFaculty of Medicine, Michigan State University, East Lansing, MI, USA.
Obieda AltobaishatFaculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Mohamed S ElgendyFaculty of Medicine, Tanta University, Tanta, Egypt.
Abdalhakim ShubietahDepartment of Medicine, Advocate Illinois Masonic Medical Center, Chicago, IL, USA.
Mohamed AbuelazmFaculty of Medicine, Tanta University, Tanta, Egypt.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCardiac computed tomography angiography (CCTA) is increasingly used to guide left atrial appendage occlusion (LAAO) by providing a detailed anatomical assessment. However, its incremental value over conventional planning methods, such as transesophageal echocardiography or fluoroscopy, remains uncertain. This study evaluated the additive value of CCTA-guided planning in percutaneous LAAO.

methodsA systematic review and meta-analysis conducted using PubMed, Embase, CENTRAL, Scopus, and Web of Science, up to September 2024 (updated in July 2025). Dichotomous outcomes were pooled as risk ratios (RR), while continuous outcomes were pooled as mean differences (MD) along the corresponding 95% confidence intervals (CI). PROSPERO ID: CRD42024600363.

resultsSix studies comprising 978 patients with follow-up periods of up to 90 days were included. The CCTA-guided group had significant higher device implantation success [RR: 1.06; 95% CI (1.01, 1.11), P = 0.028], a lower device resizing [RR: 0.42; 95% CI (0.26, 0.66), P = 0.0002], and a lower procedure time [MD: -13.29 min; 95% CI (-23.72, -2.86), P = 0.01]. There was no significant difference between the two groups in device-related embolization [P = 0.38], peri-device leakage [P = 0.16], radiation dose [P = 0.84], and contrast utilization [P = 0.96].

conclusionAdding CCTA to preoperative planning for LAAO as a complementary modality can increase implantation success rate, improve device selection accuracy, and shorten procedure time without increasing adverse events or contrast use with substantial heterogeneity and divergent subgroups. However, limited follow-up restricts long-term safety conclusions. Further large-scale, long-term randomized trials are needed to validate these findings.

Indexed as

Atrial fibrillationCardiac computed tomographyCardiac imagingCCTALAACLeft atrial appendage closure

Identifiers

PMID41903032

What OpenQuestion holds

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Read underepoch 390

Registered trials

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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.