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

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Title: Intracardiac or transesophageal echocardiography for left atrial appendage occlusion: an updated systematic review and meta-analysis.
Authors: Beneki, Eirini, Dimitriadis, Kyriakos, Theofilis, Panagiotis, Pyrpyris, Nikolaos, Iliakis, Panayiotis, Kalompatsou, Argyro, Kostakis, Panagiotis, Koukos, Markos, Soulaidopoulos, Stergios, Tzimas, Georgios, Tsioufis, Konstantinos, Lancellotti, Patrizio, Aggeli, Constantina
Source: International Journal of Cardiovascular Imaging; Mar2025, Vol. 41 Issue 3, p489-505, 17p
Abstract: 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. [ABSTRACT FROM AUTHOR]
Copyright of International Journal of Cardiovascular Imaging is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Intracardiac or transesophageal echocardiography for left atrial appendage occlusion: an updated systematic review and meta-analysis.
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  Data: 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 &lt; 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. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of International Journal of Cardiovascular Imaging is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder&#39;s express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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              Text: Mar2025
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