Volume 23 Issue 8
Aug.  2025
Turn off MathJax
Article Contents
Article Navigation >  Chinese Journal of General Practice  > 2025  >  23(8): 1373-1376
WANG Zhao, WANG Binhao, CHU Huimin, ZHANG Shengmin. The value of left atrial appendage orifice diameter in predicting peridevice leak after the implantation of WATCHMAN occluder[J]. Chinese Journal of General Practice, 2025, 23(8): 1373-1376. doi: 10.16766/j.cnki.issn.1674-4152.004137
Citation: WANG Zhao, WANG Binhao, CHU Huimin, ZHANG Shengmin. The value of left atrial appendage orifice diameter in predicting peridevice leak after the implantation of WATCHMAN occluder[J]. Chinese Journal of General Practice, 2025, 23(8): 1373-1376. doi: 10.16766/j.cnki.issn.1674-4152.004137
shu

The value of left atrial appendage orifice diameter in predicting peridevice leak after the implantation of WATCHMAN occluder

doi: 10.16766/j.cnki.issn.1674-4152.004137
  • 1.

    Department of Ultrasonography, the First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang 315000, China

Funds:

 2023S140

 2024KY1518

 2023Z188

  • Received Date: 2024-08-18
    Available Online: 2025-10-31
    Abstract
  •   Objective  Percutaneous left atrial appendage (LAA) closure has been proved to be effective in preventing ischemic stroke for patients with nonvalvular atrial fibrillation (AF). Peridevice leak (PDL) is an important parameter to determine the successful implantation of the occluder. This study aimed to investigate the value of LAA orifice diameter in predicting PDL after the implantation of WATCHMAN occluder.  Methods  A total of 293 patients with AF who underwent LAA closure with WATCHMAN occluder and finished transesophageal echocardiography (TEE) follow-up in the Arrhythmia Center of First Affiliated Hospital of Ningbo University between January 2015 and December 2020 were included. The study population was divided into two groups due to the PDL detected by TEE: PDL < 3 mm group (n=253) and PDL≥3 mm group (n=40). LAA orifice diameter was compared between groups. The relationship between LAA orifice diameter and PDL≥3 mm was analyzed by multivariable logistic regression. The accuracy of LAA orifice diameter for predicting PDL≥3 mm was evaluated by ROC curve.  Results  LAA maximal orifice diameter in the PDL≥3 mm group was larger than that in the PDL < 3 mm group [(24.4±3.3) mm vs. (22.3±3.7) mm, P=0.001]. Multivariable logistic regression showed that LAA maximal orifice diameter was associated with PDL≥3 mm (OR=1.192, 95% CI: 1.060-1.340, P=0.003). In the ROC analysis, area under the curve was 0.675 (95% CI: 0.590-0.761, P < 0.001). The cut-off value of LAA maximal orifice diameter for predicting PDL≥3 mm was 23 mm, yielding a sensitivity of 72.5% and a specificity of 56.1%.  Conclusion  LAA orifice diameter has a reference value for predicting significant PDL after the implantation of WATCHMAN occluder in patients with nonvalvular AF.

     

    • FullText(HTML)
  • loading
    • References(15)
  • [1]
    TEPPO K, AIRAKSINEN K E J, JAAKKOLA J, et al. Ischaemic stroke in women with atrial fibrillation: temporal trends and clinical implications[J]. Eur Heart J, 2024, 45(20): 1819-1827. doi: 10.1093/eurheartj/ehae198
    [2]
    JOGLAR J A, CHUNG M K, ARMBRUSTER A L, et al. 2023 ACC/AHA/ACCP/HRS guideline for the diagnosis and management of atrial fibrillation[J]. J Am Coll Cardiol, 2024, 83(1): 109-279. doi: 10.1016/j.jacc.2023.08.017
    [3]
    HINDRICKS G, POTPARA T, DAGRES N, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): the task force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC[J]. Eur Heart J, 2021, 42(5): 373-498. doi: 10.1093/eurheartj/ehaa612
    [4]
    朱静, 徐健, 苏浩, 等. 左心耳封堵治疗非瓣膜性房颤的安全性和有效性[J]. 中华全科医学, 2020, 18(8): 1261-1264. doi: 10.16766/j.cnki.issn.1674-4152.001480

    ZHU J, XU J, SU H, et al. Efficacy and safety of left atrial appendage occlusion in the therapy for non-valvular atrial fibrillation[J]. Chinese Journal of General Practice, 2020, 18(8): 1261-1264. doi: 10.16766/j.cnki.issn.1674-4152.001480
    [5]
    OSMANCIK P, HERMAN D, NEUZIL P, et al. Left atrial appendage closure versus direct oral anticoagulants in high-risk patients with atrial fibrillation[J]. J Am Coll Cardiol, 2020, 75: 3122-3135.
    [6]
    ALKHOULI M, DU C, KILLU A, et al. Clinical impact of residual leaks following left atrial appendage occlusion: insights from the NCDR LAAO registry[J]. JACC Clin Electrophysiol, 2022, 8(6): 766-778. doi: 10.1016/j.jacep.2022.03.001
    [7]
    DUKKIPATI S R, HOLMES D R, DOSHI S K, et al. Impact of peridevice leak on 5-year outcomes after left atrial appendage closure[J]. J Am Coll Cardiol, 2022, 80(5): 469-483. doi: 10.1016/j.jacc.2022.04.062
    [8]
    浙江省超声医学工程学会心脏超声专业委员会. 浙江省经食管超声心动图实践应用专家共识(二)[J]. 心电与循环, 2024, 43(2): 101-106.

    Committee of Echocardiography, Association of Ultrasound in Medicine and Engineering. The expert consensus for the application of transesophageal echocardiography in Zhejiang Province: part Ⅱ[J]. Journal of Electrocardiology and Circulation, 2024, 43(2): 101-106.
    [9]
    中华医学会心电生理和起搏分会, 中国医师协会心律学专业委员会, 左心耳封堵工作委员会. 左心耳干预预防心房颤动患者血栓栓塞事件: 目前的认识和建议(2023)[J]. 中华心律失常学杂志, 2023, 27(6): 463-489.

    Chinese Society of Pacing and Electrophysiology, Chinese Society of Arrhythmias, Working Committee on Occlusion of Left Atrial Appendage. Left atrial appendage intervention to prevent thromboembolic events in patients with atrial fibrillation: current knowledge and recommendations (2023)[J]. Chinese Journal of Cardiac Arrhythmias, 2023, 27(6): 463-489.
    [10]
    AFZAL M R, GABRIELS J K, JACKSON G G, et al. Temporal changes and clinical implications of delayed peridevice leak following left atrial appendage closure[J]. JACC Clin Electrophysiol, 2022, 8(1): 15-25. doi: 10.1016/j.jacep.2021.06.018
    [11]
    ALKHOULI M, DE BACKER O, ELLIS C R, et al. Peridevice leak after left atrial appendage occlusion: incidence, mechanisms, clinical impact, and management[J]. JACC Cardiovasc Interv, 2023, 16(6): 627-642. doi: 10.1016/j.jcin.2022.12.006
    [12]
    CHEN M, YAO P C, FEI Z T, et al. Prognostic impact of left atrial appendage patency after device closure[J]. Circ Cardiovasc Interv, 2024, 17(5): e013579. DOI: 10.1161/CIRCINTERVENTIONS.123.013579.
    [13]
    PRICE M J, ELLIS C R, NIELSEN-KUDSK J E, et al. Peridevice leak after transcatheter left atrial appendage occlusion: an analysis of the amulet IDE trial[J]. JACC Cardiovasc Interv, 2022, 15(21): 2127-2138. doi: 10.1016/j.jcin.2022.09.001
    [14]
    CHEN Y Y, ZHANG Y H, CHEN X, et al. Left atrial appendage orifice diameter measured with trans-esophageal echocardiography is independently related with peri-device leakage after watchman device implantation[J]. Int J Cardiovasc Imaging, 2019, 35(10): 1831-1839. doi: 10.1007/s10554-019-01625-6
    [15]
    KORSHOLM K, JENSEN J M, NORGAARD B L, et al. Peridevice leak following amplatzer left atrial appendage occlusion: cardiac computed tomography classification and clinical outcomes[J]. JACC Cardiovasc Interv, 2021, 14(1): 83-93. doi: 10.1016/j.jcin.2020.10.034
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(1)  / Tables(3)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (3) PDF downloads(0) Cited by()
    Proportional views
    Related

    Address：No. 287, Changhuai Road, Bengbu, Anhui Province, 233004, P.R.ChinaphoneNo：0552-3066635； 0552-3051890Email：zhqkyx@163.com

    Copyright © Chinese Journal of General Practice皖ICP备2020018345号-2

    Supported by: Beijing Renhe Information Technology Co., Ltd.    

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return