AFCA and LAA Closure
A total of 84 patients were enrolled in this study. The mean age was
68.7 ± 8.0 years, including 37 females. 38 patients were with paroxysmal
AF and 46 were with persistent AF. The mean
CHA2DS2-VASc score was 3.4 ± 1.4 and the
mean HAS-BLED score was 2.2 ± 1.2. The detailed clinical characteristics
are listed in Table 1.
Mean maximum diameter of LAA orifice
measured by TEE was 22.6 ± 3.2 mm, while 27.8 ± 5.2 mm by CCTA (Table
1). The paired t-test showed significant differences between two groups
(P < 0.001) in this study. In order to ensure the consistency
of the examination methods, the results of maximum diameter of LAA
orifice measured by CCTA were used for subsequent statistical analysis,
because CCTA was used to evaluate PDL and device endothelialization in
this study.
During the procedure, sinus rhythm (SR) was restored in all patients and
Watchman devices were all successfully implanted. Satisfactory occlusion
was achieved in 100% of patients. The results of five Watchman sizes
used were shown in Table 1. There were no bleeding events during
hospitalization and all patients were switched to OAC therapy before
discharge.
At 3 months follow-up, the satisfactory occlusion rate was 100% and all
patients were switched to DAPT accordingly. Neither bleeding, stroke,
systemic
embolic events nor device related thrombus (DRT) events were recorded
during mean 164‐day follow‐up. At 6 months follow-up, 73.2% (64/84) of
the patients maintained sinus rhythm. At 3 months TEE, 21 patients with
PDL whose width <5 mm were identified, meanwhile, 44 patients
with PDL whose width <5 mm and 7 patients with trans-fabric
leak were identified by CCTA at 6 months follow-up (Figure 2). There is
no correlation between PDL identified at 3 months follow-up by TEE and
incomplete endothelialization identified by CCTA at 6 months follow-up
(P = 0.494). The detailed TEE and CCTA results are listed in Table 2.