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Updated: Jun 15, 2026
Author Spotlight: Advancements in Intracardiac Echocardiography for Atrial Anatomy Assessment
Published on: June 30, 2023
Clinical Value of CT-Based 3D Computational Modeling in Left Atrial Appendage Occlusion: An In-Depth Analysis of the
Emmanuel De Cock1,2, Stijn Lochy3, Maximo Rivero-Ayerza4
1Department of Cardiology, AZ Sint-Jan Brugge AV, Brugge, Belgium.
Insights
FEops HEARTguide software significantly improves preprocedural planning for left atrial appendage occlusion (LAAO) by enhancing device selection accuracy and increasing clinician confidence. This advanced CT-based modeling aids in better patient outcomes for LAAO procedures.
Area of Science:
- Cardiology
- Medical Imaging
- Computational Modeling
Background:
- Standard of care (SoC) assessment for left atrial appendage occlusion (LAAO) using computed tomography (CT) and transesophageal echocardiography is often insufficient for optimal preprocedural evaluation.
- CT-based 3D computational modeling, specifically FEops HEARTguide, offers a potential improvement for assessing LAA-device interaction.
Purpose of the Study:
- To evaluate the decisional impact of FEops HEARTguide in the preprocedural planning of LAAO procedures.
- To assess if FEops improves device size selection and clinician certainty compared to standard methods.
Main Methods:
- A prospective, multi-center, self-controlled study (PRECISE LAAO) evaluated FEops for LAAO with the Amulet device.
- Clinicians recorded device size selection and certainty (0-10) before and after using FEops.
- Concordance with the implanted device and subjective clinician ratings of FEops' helpfulness were assessed.
Main Results:
- FEops use increased concordance between planned and implanted device size from 59.8% (SoC) to 90.2% (FEops, p < 0.0001).
- FEops prompted a size change in 35 patients, with 33 (32.4%) being correct adjustments.
- Clinician certainty increased from 6.7 ± 1.3 (SoC) to 7.6 ± 1.3 (FEops, p < 0.0001), with 90.2% rating FEops as helpful.
Conclusions:
- CT-based computational modeling with FEops significantly impacts decision-making in LAAO.
- FEops leads to improved Amulet device size selection in nearly one-third of patients and enhances procedural confidence.
- FEops HEARTguide is a valuable tool for optimizing preprocedural planning in LAAO.
Background:
Standard of care (SoC) assessment based on computed tomography (CT) and/or transesophageal echocardiography is suboptimal for adequate preprocedural evaluation for left atrial appendage occlusion (LAAO). This can be improved through CT-based 3D computational modeling of the LAA-device interaction using FEops HEARTguide. This study aims to assess the decisional impact of FEops in preprocedural planning for LAAO.
Methods:
The PRECISE LAAO is a prospective multi-center self-controlled study evaluating the use of FEops in LAAO with Amulet. Preprocedural device size selection and degree of certainty (scale 0-10) were registered before (Decision SoC) and after accessing FEops (Decision FEops), followed by device implantation. Concordance was compared between the Decisions and the final implanted device. After the procedure, clinicians rated the subjective value of FEops on a scale from -3 (futile) to +3 (most helpful).
Results:
One hundred two patients were included. Decision SoC was concordant with the implanted device in 61 patients (59.8%), whereas Decision FEops was concordant in 92 (90.2%, p < 0.0001). FEops induced a size change in 35 patients, which was correct in 33 (32.4%). Certainty SoC was 6.7 ± 1.3 and increased after FEops assessment to 7.6 ± 1.3 (p < 0.0001). In the 33 patients with FEops-induced positive corrections, Certainty SoC was lower (6.2 ± 1.5, suggesting a more complex procedure) and increased to 7.2 ± 1.2 with FEops (p = 0.004). Clinicians rated FEops as helpful (subjective score ≥ 1) in 90.2% of cases.
Conclusions:
CT-based computational modeling using FEops has a positive decisional impact in LAAO, inducing a change in Amulet size selection in almost one out of three patients and increasing procedural confidence. Trials Trial Registration: NCT04640051.
