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Related Experiment Video

Updated: Feb 13, 2026

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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New Measurements Using Computed Tomography Predict Success of Left Atrial Appendage Closure.

Ryo Yamaguchi1, Masanori Yamamoto1,2,3, Mitsuru Sago1

  • 1Department of Cardiology, Toyohashi Heart Center, Toyohashi, Japan.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|February 11, 2026
PubMed
Summary
This summary is machine-generated.

A new CT-based ratio (Rcal) effectively predicts procedural success for left atrial appendage closure (LAAC). This metric improves patient selection and planning for Watchman FLX device implantation.

Keywords:
Watchman FLXcontrast‐enhanced computed tomographydepth‐to‐ostiumpredictive performancetransesophageal echocardiography

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Area of Science:

  • Cardiovascular Imaging
  • Interventional Cardiology
  • Medical Device Technology

Background:

  • Transesophageal echocardiography (TEE) and computed tomography (CT) are standard for preprocedural screening in left atrial appendage closure (LAAC).
  • Accurate prediction of procedural device success (DS) for LAAC remains a challenge with current methods.

Purpose of the Study:

  • To evaluate a novel CT-based assessment for predicting DS in LAAC.
  • To determine if a CT-derived ratio, considering landing zone and internal septum, improves DS prediction.

Main Methods:

  • Analysis of 560 patients undergoing LAAC with Watchman FLX from a Japanese registry.
  • Preprocedural CT measurements included LAA landing zone diameter (Dland), LAA length (L), and major lobe ostium diameter (Dlobe).
  • A novel ratio (Rcal = L/(Dland-Dlobe)) was calculated and its predictive performance assessed via ROC analysis.

Main Results:

  • Device success (DS) was achieved in 95.5% of patients.
  • The Rcal was significantly lower in the device failure group (0.66 ± 0.25) compared to the success group (1.00 ± 0.28).
  • Rcal demonstrated superior predictive performance (AUC: 0.872) compared to conventional CT (AUC: 0.552) and TEE (AUC: 0.456) derived ratios.

Conclusions:

  • The novel CT-derived metric, Rcal, accurately predicts device success for Watchman FLX implantation.
  • Rcal accounts for LAA landing zone dimensions and internal septa, offering improved predictive capabilities.
  • This metric may enhance pre-LAAC patient selection and procedural planning.