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.