Abstract
Introduction: Trans-oesophageal echocardiography (TOE) has long been the gold standard for assessment of the left atrial appendage (LAA). In the COVID-19 pandemic Australian and international guidelines recommend avoiding aerosol generating procedures (AGP). Computed tomography left atrial appendage (CTLAA) is not an AGP and has a negative predictive value for LAA thrombus of 99% in meta-analyses. CTLAA has been endorsed by the Society of Cardiac Computed Tomography to exclude LAA thrombus but is not used widely in Australia outside of pulmonary vein isolation and LAA occlusion device insertion planning.
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