Key result
ICE shows promise for guiding LAAC by reducing fluoroscopy and avoiding general anesthesia.
Why the study?
Intracardiac echocardiography is a promising new imaging modality for guiding left atrial appendage closure, prompting a review of strategies for its use in clinical policy.
Does intracardiac echocardiography provide procedural advantages and improve safety for guiding left atrial appendage closure in patients with nonvalvular atrial fibrillation?
Does intracardiac echocardiography provide procedural advantages and improve safety for guiding left atrial appendage closure in patients with nonvalvular atrial fibrillation?
Intracardiac echocardiography is a promising and advantageous imaging modality for guiding left atrial appendage closure, offering benefits such as the avoidance of general anesthesia and reduced fluoroscopy time.
ICE-guided LAAC may offer a TEE alternative in select patients; leaves open need for RCTs on safety and outcomes.
Background and Aims: Percutaneous transcatheter left atrial appendage (LAA) closure (LAAC) is an effective approach for preventing ischemic stroke in nonvalvular atrial fibrillation patients. Intracardiac echocardiography (ICE), a new imaging modality, is a promising strategy for guiding LAAC. This review highlights the various strategies for ICE-guided-LAAC as an option for clinical policy. Methods: A comprehensive literature search was conducted of PubMed, ScienceDirect, Ovid Web of Science, SpringerLink, and other notable databases to identify recent peer-reviewed clinical trials, reviews, and research articles related to ICE and its application in the guidance of LAAC. Results: Various methods are used to evaluate the spatial structure and dimensions of the LAA. The main techniques for guiding LAAC are transesophageal echocardiography (TEE), cardiac computed tomography (CTA), and ICE. Among these techniques, the advantages of ICE typically include (1) multiangle and real-time assessment of intracardiac structure, (2) a reduction in procedural fluoroscopy, (3) reduced operation time and improved workflow in the catheterization laboratory, and (4) the avoidance of general anesthesia and the early detection of complications. Conclusion: ICE is a promising strategy for the guidance of LAAC. Among the most advanced and recent technological innovations in cardiovascular imaging in general and volume imaging in particular, ICE offers greater efficacy and safety.
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Ding et al. (2023) conducted a review in Nonvalvular atrial fibrillation. Intracardiac echocardiography (ICE) vs. Transesophageal echocardiography (TEE) and cardiac computed tomography (CTA) was evaluated. Intracardiac echocardiography is a promising strategy for guiding left atrial appendage closure, offering multiangle real-time assessment, reduced fluoroscopy, and avoidance of general anesthesia.
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