{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T09:32:58Z","timestamp":1790415178123,"version":"4.1.0"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2024,5,1]],"date-time":"2024-05-01T00:00:00Z","timestamp":1714521600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Interventions"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>The prognostic impact of left atrial appendage (LAA) patency, including those with and without visible peri-device leak (PDL), post\u2013LAA closure in patients with atrial fibrillation, remains elusive.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>Patients with atrial fibrillation implanted with the WATCHMAN 2.5 device were prospectively enrolled. The device surveillance by cardiac computed tomography angiography was performed at 3 months post-procedure. Adverse events, including stroke\/transient ischemic attack (TIA), major bleeding, cardiovascular death, all-cause death, and the combined major adverse events (MAEs), were compared between patients with complete closure and LAA patency.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              Among 519 patients with cardiac computed tomography angiography surveillance at 3 months post\u2013LAA closure, 271 (52.2%) showed complete closure, and LAA patency was detected in 248 (47.8%) patients, including 196 (37.8%) with visible PDL and 52 (10.0%) without visible PDL. During a median of 1193 (787\u20131543) days follow-up, the presence of LAA patency was associated with increased risks of stroke\/TIA (adjusted hazard ratio for baseline differences, 3.22 [95% CI, 1.17\u20138.83];\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.023) and MAEs (adjusted hazard ratio, 1.12 [95% CI, 1.06\u20131.17];\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.003). Specifically, LAA patency with visible PDL was associated with increased risks of stroke\/TIA (hazard ratio, 3.66 [95% CI, 1.29\u201310.42];\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.015) and MAEs (hazard ratio, 3.71 [95% CI, 1.71\u20138.07];\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.001), although LAA patency without visible PDL showed higher risks of MAEs (hazard ratio, 3.59 [95% CI, 1.28\u201310.09];\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.015). Incidences of stroke\/TIA (2.8% versus 3.0% versus 6.7% versus 22.2%;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.010), cardiovascular death (0.9% versus 0% versus 1.7% versus 11.1%;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.005), and MAEs (4.6% versus 9.0% versus 11.7% versus 22.2%;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.017) increased with larger PDL (0, &gt;0 to \u22643, &gt;3 to \u22645, or &gt;5 mm). Older age and discontinuing antiplatelet therapy at 6 months were independent predictors of stroke\/TIA and MAEs in patients with LAA patency.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>LAA patency detected by cardiac computed tomography angiography at 3 months post\u2013LAA closure is associated with unfavorable prognosis in patients with atrial fibrillation implanted with WATCHMAN 2.5 device.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>REGISTRATION:<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT03788941.\n            <\/jats:p>\n          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