Does an ultralow-dose fluoroscopy strategy reduce radiation exposure and procedure time without compromising safety and efficacy compared to standard fluoroscopy in patients undergoing left atrial appendage occlusion?
PPopulation184 propensity score-matched patients (46 ultralow-dose, 138 standard-dose) undergoing left atrial appendage occlusion (LAAO) at a single center (Cleveland Clinic). Median age 75.5, 41.3% male, median CHA2DS2-VASc score 4.
IInterventionUltralow-dose fluoroscopy strategy (target total radiation dose <10 mGy) using an echo-forward workflow with intracardiac echocardiography (ICE) and transesophageal echocardiography (TEE) guidance for LAAO device placement.
CComparatorStandard fluoroscopy-guided LAAO using propensity score matching (1:3 ratio).
OOutcomeProcedural metrics (procedure duration, fluoroscopy time, radiation dose) and periprocedural adverse events (within 7 days or before discharge).safety
An ultralow-dose fluoroscopy strategy for LAAO using ICE and TEE guidance significantly reduces radiation exposure and procedure time while maintaining comparable safety and efficacy to standard fluoroscopy.