Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Echocardiographic-Fluoroscopic Fusion Imaging Improves Interventionalists´ Learning Curve for Percutaneous Left Atrial Appendage Closure

Dominika Anna Kanschik
,
Houtan Heidari
,
Kathrin Klein
,
Amin Polzin
ORCID logo ,
Verena Veulemans
,
Jürgen Leick
,
Malte Kelm
,
Christian Jung
ORCID logo ,
Tobias Zeus
* ORCID logo ,
Shazia Samreen Afzal
Version 1 : Received: 30 August 2023 / Approved: 30 August 2023 / Online: 31 August 2023 (10:36:53 CEST)

How to cite: Kanschik, D. A.; Heidari, H.; Klein, K.; Polzin, A.; Veulemans, V.; Leick, J.; Kelm, M.; Jung, C.; Zeus, T.; Afzal, S. S. Echocardiographic-Fluoroscopic Fusion Imaging Improves Interventionalists´ Learning Curve for Percutaneous Left Atrial Appendage Closure. Preprints 2023, 2023082126. https://doi.org/10.20944/preprints202308.2126.v1 Kanschik, D. A.; Heidari, H.; Klein, K.; Polzin, A.; Veulemans, V.; Leick, J.; Kelm, M.; Jung, C.; Zeus, T.; Afzal, S. S. Echocardiographic-Fluoroscopic Fusion Imaging Improves Interventionalists´ Learning Curve for Percutaneous Left Atrial Appendage Closure. Preprints 2023, 2023082126. https://doi.org/10.20944/preprints202308.2126.v1

Abstract

Due to the complex and variable anatomy of the left atrial appendage, percutaneous left atrial appendage closure (LAAC) can be challenging. In this study, we investigated the impact of fusion imaging (FI) on the LAAC learning curve of 2 interventionalists. The first interventionalist (IC 1) was initially trained without FI and continued his training with FI. The second interventionalist (IC 2) performed all procedures with FI. We compared the first 36 procedures without FI of IC 1 (group 1) with his next 36 interventions with FI (group 2). Furthermore, group 1 was compared to 36 procedures of IC 2 who directly started his training with FI (group 3). Group 1 demonstrated that the learning curve without FI has a flat course with weak correlations for fluoroscopy time, contrast volume, and procedure time, but not for dose area product. Group 2 with FI showed improvement with a steep course and strong correlations for all 4 parameters. In group 3 we also saw a steep progression with strong correlations. Furthermore, the mean measurements of the procedural parameters in the groups with FI decreased significantly as indicator for procedural efficacy. We demonstrated that FI may improve the learning curve of experienced and non-experienced ICs.

Keywords

structural heart disease; left atrial appendage closure; fusion imaging; learning curve

Subject

Medicine and Pharmacology, Internal Medicine

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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