The use of intracardiac echocardiography during endocardial ablation significantly reduced fluoroscopy time (Hedges' g -1.06; 95% CI -1.81 to -0.32; P < .01) compared to ablation without ICE.
Meta-Analysis (n=2,186)
Does the use of intracardiac echocardiography reduce fluoroscopy time, fluoroscopy dose, and procedure time during endocardial ablation of cardiac arrhythmias?
The use of intracardiac echocardiography during endocardial ablation significantly reduces fluoroscopy time, fluoroscopy dose, and procedure time without compromising safety or effectiveness.
Standardized Mean Difference: -1.06 (95% CI -1.81–-0.32)
p-value: p=< .01
AIMS: The optimal use of intracardiac echocardiography (ICE) may reduce fluoroscopy time and procedural complications during endocardial ablation of cardiac arrhythmias. Due to limited evidence in this area, we conducted the first systematic literature review and meta-analysis to evaluate outcomes associated with the use of ICE. METHODS AND RESULTS: Studies reporting the use of ICE during ablation procedures vs without ICE were searched using PubMed/MEDLINE. A meta-analysis was performed on the 19 studies (2186 patients) meeting inclusion criteria, collectively representing a broad range of arrhythmia mechanisms. Use of ICE was associated with significant reductions in fluoroscopy time (Hedges' g -1.06; 95% confidence interval CI -1.81 to -0.32; P < .01), fluoroscopy dose (Hedges' g -1.27; 95% CI -1.91 to -0.62; P < .01), and procedure time (Hedges' g -0.35; 95% CI -0.64 to -0.05; P = .02) vs ablation without ICE. A 6.95 minute reduction in fluoroscopy time and a 15.2 minute reduction in procedure time was observed between the ICE vs non-ICE groups. These efficiency gains were not associated with any decreased effectiveness or safety. Sensitivity analyses limiting studies to an atrial fibrillation (AF) only population yielded similar results to the main analysis. CONCLUSION: The use of ICE in the ablation of cardiac arrhythmias is associated with significantly lower fluoroscopy time, fluoroscopy dose, and shorter procedure time vs ablation without ICE. These efficiency improvements did not compromise the clinical effectiveness or safety of the procedure.
Goya et al. (Fri,) conducted a meta-analysis in Cardiac arrhythmias (n=2,186). Intracardiac echocardiography (ICE) vs. Ablation without ICE was evaluated on Fluoroscopy time (Hedges' g -1.06, 95% CI -1.81 to -0.32, p=< .01). The use of intracardiac echocardiography during endocardial ablation significantly reduced fluoroscopy time (Hedges' g -1.06; 95% CI -1.81 to -0.32; P < .01) compared to ablation without ICE.
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