Device Implantation Outcomes
The LAAC immediate device implantation success rate was not significantly different (p=0.63) in the two groups, 98% in the single procedure group and 100% in the combined strategy group (Table 2). The 2 procedural failures were related to unfavorable anatomy and a high risk of prosthesis embolization after assessment of the PASS criteria. Median procedural time was 69 min (IQR 25/75 53/88) and 115 min (IQR 25/75 76-139), median fluoroscopy time 7 min (IQR 25/75 5-10) and 18 min (IQR 25/75 10-38), median fluoroscopy dose 945 mGy (IQR 25/75 402/2760) and 2500 mGy (IQR 25/75 640/11992) in the single procedure and combined strategy groups, respectively (p<0.01). Recapture or device resizing were required in 42 patients (27%).
The combined strategy included 6 TEMVR (37%), 6 typical atrial flutter ablation (AFL) (37%), 2 LP implantation (13%) and 2 atrial fibrillation ablation (13%). Among the 6 patients undergoing a typical flutter ablation, 3 were in flutter at time of LAAC and sinus rhythm was obtained in all. Procedural time, fluoroscopy duration and fluoroscopy dose was significantly lower for AFL (table 3).