Comparison of intracardiac echocardiography with transesophageal echocardiography for left atrial appendage occlusion: an updated systematic review and meta-analysis

Excerpt

Left atrial appendage occlusion (LAAO) has emerged as a feasible alternative to oral anticoagulation therapy, in patients with AF that are unable to tolerate long-term anticoagulation. Transesophageal echocardiography (TEE) is the most widely used imaging modality for most patients undergoing LAAO implantation [1]. However, the use of TEE for LAAO implantation typically requires the use of general anesthesia, a dedicated imaging cardiologist, and it may be associated with a longer post-procedure recovery time for patients. Intracardiac echocardiography (ICE) has emerged as an alternative, and it offers several advantages when compared to TEE as it can be performed under conscious sedation and improves the efficiency of the catheterization laboratory, and this in turn may facilitate a same-day discharge [2]. There is a paucity of outcome data comparing ICE versus TEE in patients, and previous meta-analyses were unable to demonstrate the superiority of one imaging modality over the other. In this updated meta-analysis, which is the largest to date, we compared clinical outcomes between ICE vs TEE in patients undergoing LAAO implantation. …