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Background <p>Intracardiac echocardiography (ICE) appears to be a potential alternative for percutaneous left atrial appendage occlusion (LAAO) to transesophageal echocardiography (TEE). Thus, a meta-analysis was performed comparing ICE vs. TEE for LAAO guidance.</p> Methods <p>A comprehensive literature search was performed using MEDLINE, Scopus and Web of Science electronic databases from their inception to November 2023.</p> Results <p>18 studies (124,230 patients) were included. Technical success was higher in ICE- compared to TEE-guidance (OR: 1.36, 95% CI 1.14 to 1.63, <i>p</i> = 0.006) and fewer devices employed (SMD: -0.22, 95% CI -0.43 to -0.01, <i>p</i> = 0.04, I2 = 62%). ICE guidance related with more pericardial effusion/tamponade and iatrogenic residual shunts (logRR: 0.62, 95% CI 0.36 to 0.89, <i>p</i> &lt; 0.001 and RR: 1.53, 95% CI 1.12 to 2.09, <i>p</i> = 0.02, I2 = 1%, respectively). More vascular complications were noted in ICE group (logRR: 0.45, 95% CI 0.11 to 0.78, <i>p</i> = 0.009).</p> Conclusion <p>ICE-guided imaging is an effective alternative to TEE in LAAO, as it shows better efficacy than TEE, considering technical success. However, the higher rates of adverse events should be carefully considered.</p>

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Intracardiac or transesophageal echocardiography for left atrial appendage occlusion: an updated systematic review and meta-analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年1月22日

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  • Eirini Beneki,
  • Kyriakos Dimitriadis,
  • Panagiotis Theofilis,
  • Nikolaos Pyrpyris,
  • Panayiotis Iliakis,
  • Argyro Kalompatsou,
  • Panagiotis Kostakis,
  • Markos Koukos,
  • Stergios Soulaidopoulos,
  • Georgios Tzimas,
  • Konstantinos Tsioufis,
  • Patrizio Lancellotti,
  • Constantina Aggeli

摘要

Background

Intracardiac echocardiography (ICE) appears to be a potential alternative for percutaneous left atrial appendage occlusion (LAAO) to transesophageal echocardiography (TEE). Thus, a meta-analysis was performed comparing ICE vs. TEE for LAAO guidance.

Methods

A comprehensive literature search was performed using MEDLINE, Scopus and Web of Science electronic databases from their inception to November 2023.

Results

18 studies (124,230 patients) were included. Technical success was higher in ICE- compared to TEE-guidance (OR: 1.36, 95% CI 1.14 to 1.63, p = 0.006) and fewer devices employed (SMD: -0.22, 95% CI -0.43 to -0.01, p = 0.04, I2 = 62%). ICE guidance related with more pericardial effusion/tamponade and iatrogenic residual shunts (logRR: 0.62, 95% CI 0.36 to 0.89, p < 0.001 and RR: 1.53, 95% CI 1.12 to 2.09, p = 0.02, I2 = 1%, respectively). More vascular complications were noted in ICE group (logRR: 0.45, 95% CI 0.11 to 0.78, p = 0.009).

Conclusion

ICE-guided imaging is an effective alternative to TEE in LAAO, as it shows better efficacy than TEE, considering technical success. However, the higher rates of adverse events should be carefully considered.