Arrhythmias & electrophysiology
Intracardiac Versus Transesophageal Echocardiography for Left Atrial Appendage Occlusion: A Meta-Analysis
Authors' conclusion
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).
Study context
- Population
- Patients undergoing left atrial appendage occlusion guided by intracardiac echocardiography (ICE) or transesophageal echocardiography (TEE)observational studies, of which 9 studies reported adjusted summary estimates
- Participants
- 27 patients
- Comparison
- ICE vs TEE during left atrial appendage occlusion
Methodological detailsrandom-effects model, 27 observational studies, subgroup analysis for unadjusted and adjusted data
- Random-effects model
- 27 observational studies
- Subgroup analysis for unadjusted and adjusted data
Pooled result
As reported in the abstract
Procedural success
ICE vs TEEOdds ratio (95% CI)
Unadjusted; I2 = 0%
1.16(0.92–1.45)
Adjusted; I2 = NA
1.40(0.99–1.98)
Further pooled results
| Outcome | MD (minutes) (95% CI) | |
|---|---|---|
| Procedure duration — ICE vs TEE · adjusted; shorter with ICE; I2 = 0% | −20.76 (−26.99 to −14.53) | |
| −40−20020Difference, minutes (linear scale) |
| Outcome | MD (95% CI) | |
|---|---|---|
| Procedure duration — ICE vs TEE · unadjusted; no difference; I2 = 95% | −0.13 (−5.40 to 5.14) | |
| −10−50510Difference (linear scale) |
Safety
| Outcome | OR (95% CI) | |
|---|---|---|
| In-hospital pericardial effusion requiring intervention — ICE vs TEE · unadjusted; higher with ICE; I2 = 9% | 1.52 (1.13–2.04) | |
| In-hospital pericardial effusion requiring intervention — ICE vs TEE · adjusted; higher with ICE; I2 = 8% | 1.74 (1.15–2.64) | |
| Residual iatrogenic atrial septal defect · <4 months · unadjusted; higher with ICE; I2 = 0% | 1.61 (1.20–2.16) | |
| 0.20.5125Odds ratio (log scale) |
Original publication
Intracardiac Versus Transesophageal Echocardiography for Left Atrial Appendage Occlusion: A Meta-Analysis. JACC Adv. Published 20 May 2026. doi:10.
Summarised from the published abstract; every number is checked against it