Does intracardiac echocardiography improve procedural success and safety compared to transesophageal echocardiography in patients undergoing left atrial appendage occlusion?
ICE provides comparable procedural success to TEE for LAA occlusion and shortens procedure time, but carries a higher risk of pericardial effusion and residual atrial septal defects.
BACKGROUND: The optimal imaging modality for guiding left atrial appendage occlusion remains unclear. OBJECTIVES: The authors compared the effectiveness and safety of intracardiac echocardiography (ICE) vs transesophageal echocardiography (TEE) during left atrial appendage occlusion. METHODS: Electronic databases were searched through November 2025 for studies that compared procedural success and safety with ICE vs TEE. We pooled data using a random-effects model to calculate ORs for categorical outcomes and mean differences (MDs) for continuous variables. A subgroup analysis was performed for unadjusted and adjusted data. RESULTS: = 0%). CONCLUSIONS: ICE and TEE demonstrated comparable procedural success. However, ICE was associated with shorter procedural duration at the expense of a higher incidence of intervention-requiring pericardial effusion and residual iatrogenic atrial septal defect. (Intracardiac versus Transesophageal Echocardiography for Left Atrial Appendage Occlusion: A Meta-Analysis Stratified by Adjusted and Unadjusted Subgroups; CRD420251243170).
Yaser et al. (Wed,) studied this question.
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