{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:38:07Z","timestamp":1786977487523,"version":"build-2736575974"},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,3,9]],"date-time":"2023-03-09T00:00:00Z","timestamp":1678320000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Atrial fibrillation (AF) is the most common arrhythmia and can be treated with catheter ablation (CA) combined with left atrial appendage occlusion (LAAO). The study is designed to compare the safety and efficacy of guiding the combined procedure by digital subtraction angiography (DSA) with or without transesophageal echocardiography (TEE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>From February 2019 to December 2020, 138 patients with nonvalvular AF who underwent CA combined with LAAO procedure were consecutively included, and two cohorts were built according to intraprocedural guidance (DSA or DSA with TEE). Periprocedural and follow\u2010up outcomes were compared with investigate the feasibility and safety between the two cohorts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      71 patients and 67 patients were included in the DSA cohort and TEE cohort, respectively. Age and gender were comparable, despite the TEE cohort having a higher proportion of persistent AF (37 [55.2%] vs. 26 [36.6%]) and hemorrhage history (9 [13.4%] vs. 0). The procedure time of the DSA cohort was significantly reduced (95.7\u2009\u00b1\u200927.6\u00a0vs. 108.9\u2009\u00b1\u200930.3\u2009min,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.018), with a nonsignificant longer fluoroscopic time (15.2\u2009\u00b1\u20095.4\u00a0vs. 14.4\u2009\u00b1\u20097.1\u2009min,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.074). And the overall incidence of peri\u2010procedural complications was similar between cohorts. After an average of 24 months of clinical follow\u2010up, only three patients in the TEE cohort had \u22643\u2009mm residual flow (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.62). Kaplan\u2013Meier estimates showed nonsignificant differences between the cohorts for freedom from atrial arrhythmia (log\u2010rank\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.964) and major adverse cardiovascular events (log\u2010rank\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.502).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Compared with DSA and TEE guidance, DSA\u2010guided combined procedure could shorten the procedural time, while achieving similar periprocedural and long\u2010term feasibility and safety.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/clc.23993","type":"journal-article","created":{"date-parts":[[2023,3,10]],"date-time":"2023-03-10T02:32:34Z","timestamp":1678415554000},"page":"549-557","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Guiding atrial fibrillation ablation combined with left atrial appendage occlusion procedure by fluoroscopy with or without transesophageal echocardiography achieved comparable outcomes"],"prefix":"10.1002","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3664-2756","authenticated-orcid":false,"given":"Weilun","family":"Meng","sequence":"first","affiliation":[{"name":"Department of Cardiology, Shanghai Tenth People's Hospital Tongji University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Shanghai Tenth People's Hospital 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