{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T16:59:23Z","timestamp":1785257963126,"version":"3.55.0"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"14","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,7,21]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Evidence regarding the link between imaging modality and stroke prevention outcomes of left atrial appendage occlusion is currently lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">The RECORD (Registry to Evaluate Chinese Real\u2010World Clinical Outcomes in Patients With AF Using the WATCHMAN Left Atrial Appendage Closure Technology) trial prospectively enrolled 3096 consecutive patients undergoing left atrial appendage occlusion from 39 Chinese centers between April 1, 2019, and October 31, 2020. In the current analyses, patients were stratified into the echocardiographic guidance (transesophageal echocardiography\/intracardiac echocardiography) group and the fluoroscopy\u2010only group. The primary end point was the composite end point of death, stroke, or systemic embolism at 3\u2009years. Outcomes were estimated using the Kaplan\u2013Meier method. Inverse probability of treatment weighting and 1:1 propensity score matching were performed to calculate hazard ratios (HRs) for each outcome at the time of interest.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Among 3096 participants, 2603 (84.1%) underwent transesophageal echocardiography\/intracardiac echocardiography\u2013guided procedures and 493 (15.9%) underwent fluoroscopy\u2010only guided procedures. Before discharge, procedural complications occurred in 34 patients (1.4%) in the transesophageal echocardiography\/intracardiac echocardiography group and 3 patients (0.6%) in the fluoroscopy\u2010only group (inverse probability of treatment weighting\u2013adjusted absolute difference, \u22120.67 [95% CI, \u22121.39 to 0.05],\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.066). At 3\u2010year follow\u2010up (completed by 2989 patients, 97.0%), the primary end point occurred in 269 (10.5%) patients in the transesophageal echocardiography\/intracardiac echocardiography group and 52 (10.6%) patients in the fluoroscopy\u2010only group (inverse probability of treatment weighting\u2013adjusted HR, 1.13 [95% CI, 0.81\u20131.57],\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.469). Ischemic stroke was comparable between groups (3.0% versus 4.1%, inverse probability of treatment weighting\u2013adjusted HR, 1.66 [95% CI, 0.95\u20132.89],\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.073). These findings remained consistent across patient risk profiles and operator experience levels.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Fluoroscopy\u2010only guidance, without compromising long\u2010term stroke prevention efficacy, may serve as a streamlined and potentially accessible alternative for left atrial appendage occlusion procedures performed with the first\u2010generation WATCHMAN 2.5 device, and these findings apply to select patients and experienced centers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p xml:lang=\"en\">\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: NCT03917563.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.126.049309","type":"journal-article","created":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T03:25:23Z","timestamp":1783740323000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of Fluoroscopy\u2010Only Versus Transesophageal Echocardiography\/Intracardiac Echocardiography Guidance in Left Atrial Appendage Occlusion on Stroke Prevention: Analysis From the RECORD I Study"],"prefix":"10.1161","volume":"15","author":[{"given":"Ping","family":"Wang","sequence":"first","affiliation":[{"name":"Xijing Hospital, The Fourth Military Medical University","place":["Xi\u2019an, 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