Consistency of selective angiography and transesophageal echocardiography in measure left atrial appendage in patients with atrial fibrillation

Abstract

Objective This study aimed to explore consistency of angiography and transesophageal echocardiography(TEE)in measure left atrial appendage (LAA) orifice diameter and depth in patients with atrial fibrillation(AF), and to provide the best treatment options for future LAA closure. Methods Selected AF patients who underwent radiofrequency ablation, all patients went through preoperative TEE and intraoperative selective angiography to measure LAA orifice diameter and depth. Paired t-test, Pearson correlation analysis and Bland-Altman analysis were used to evaluate the relevance and consistency of the two measurement methods. Results Forty three patients were enrolled, and the average age was (69.2±8.3) years, male was 21(48.8%). Paired t test demonstrated that it did not significantly differ between intraoperative angiography and preoperative TEE in measure LAA orifice diameter[ (24.13±4.45) mm vs.(23.37±4.60) mm, P=0.060)] and depth[(25.76±6.47) mm vs.(26.47±6.78) mm, P=0.212) ]. Pearson correlation analysis showed that the two ways to measure the LAA orifice diameter and depth were positively correlated (r=0.905, 0.906, all P<0.001). Bland-Altman method showed that the two methods for measuring consistency range limits of LAA orifice diameter were (-2.90 mm, 4.86 mm) and depth were (-6.57 mm, 4.73 mm), of which were 4.65% (2/43) points outside the range of 95% limits of agreement. Within the range limits of consistency, the maximum absolute value of difference about LAA orifice diameter and depth were 4.2 mm, 5 mm, which had a good consistency. Conclusion There was a high consistency between selective angiography and TEE in measure LAA orifice diameter and depth in patients with AF. The selective angiography of LAA can be used to guide the LAA closure in AF patients in experienced centers in the future. Key words: Atrial fibrillation; Selective angiography; Transesophageal echocardiography; left atrial appendage; Consistency