Key result
Echocardiographic-fluoroscopic fusion imaging significantly decreased mean procedural parameters and improved the learning curve for percutaneous left atrial appendage closure.
Why the study?
Due to the complex and variable anatomy of the left atrial appendage, percutaneous left atrial appendage closure can be challenging, motivating an evaluation of fusion imaging on the interventionalist learning curve.
Does echocardiographic-fluoroscopic fusion imaging improve the learning curve for percutaneous left atrial appendage closure?
Observational (n=108)
Does echocardiographic-fluoroscopic fusion imaging improve the learning curve for percutaneous left atrial appendage closure?
Echocardiographic-fluoroscopic fusion imaging improves the learning curve and procedural efficacy for both experienced and non-experienced interventionalists performing left atrial appendage closure.
Fusion imaging may shorten LAA closure procedures and flatten learning curves; leaves open need for randomized confirmation.
Due to the complex and variable anatomy of the left atrial appendage, percutaneous left atrial appendage closure (LAAC) can be challenging. In this study, we investigated the impact of fusion imaging (FI) on the LAAC learning curve of 2 interventionalists. The first interventionalist (IC 1) was initially trained without FI and continued his training with FI. The second interventionalist (IC 2) performed all procedures with FI. We compared the first 36 procedures without FI of IC 1 (group 1) with his next 36 interventions with FI (group 2). Furthermore, group 1 was compared to 36 procedures of IC 2 who directly started his training with FI (group 3). Group 1 demonstrated that the learning curve without FI has a flat course with weak correlations for fluoroscopy time, contrast volume, and procedure time, but not for dose area product. Group 2 with FI showed improvement with a steep course and strong correlations for all 4 parameters. In group 3 we also saw a steep progression with strong correlations. Furthermore, the mean measurements of the procedural parameters in the groups with FI decreased significantly as indicator for procedural efficacy. We demonstrated that FI may improve the learning curve of experienced and non-experienced ICs.
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Kanschik et al. (2023) conducted an observational in Percutaneous left atrial appendage closure (n=108). Echocardiographic-Fluoroscopic Fusion Imaging vs. Without fusion imaging was evaluated on Learning curve parameters (fluoroscopy time, contrast volume, procedure time, dose area product). Echocardiographic-fluoroscopic fusion imaging significantly decreased mean procedural parameters and improved the learning curve for percutaneous left atrial appendage closure.
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