Arrhythmias & electrophysiology
Intracardiac vs transesophageal echocardiography for left atrial appendage occlusion: An updated systematic review and meta-analysis
Pooled result · Procedural successResult — go to the resultOdds ratio 1.33 95% CI 1.01–1.76Authors' conclusion
In this updated meta-analysis, the increasing adoption of ICE-guided LAAO demonstrated higher procedural success rates compared to TEE, although with limited statistical significance. Overall complication rates were similar; however, ICE showed higher rates of pericardial effusion and residual iASD.
Study context
- Population
- Patients undergoing left atrial appendage occlusion (LAAO)
- Participants
- 42,474 patients · 19 observational studies
- Comparison
- Intracardiac echocardiography (ICE) vs transesophageal echocardiography (TEE) to guide LAAO
- ICEn = 4,415
- Outcome
- Procedural success (primary effectiveness); overall complications rate (primary safety)
Methodological detailsrandom-effects model
- Random-effects model
Pooled result
Procedural success
Odds ratio
1.33
95% CI 1.01–1.76
P = 0.04
ICE vs TEE
OR 1.33 (95% CI 1.01–1.76); P = 0.04
As reported in the abstract
Further pooled results
Procedural success within ICE, by study region (subgroup)
- Variations across study regions
- P = 0.02
Safety
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Pericardial effusionI2 = 0% | 2.11 (1.47–3.03) | P < 0.001 | |
| Residual iatrogenic atrial septal defect (iASD)I2 = 0% | 1.52 (1.15–2.03) | P < 0.004 | |
| 0.20.5125Odds ratio (log scale) |
Overall complications rate (primary safety endpoint)
- No significant difference in overall complications rate
- OR 1.02; 95% CI 0.77-1.36; P = .89; I2 = 5%
Original publication
Intracardiac vs transesophageal echocardiography for left atrial appendage occlusion: An updated systematic review and meta-analysis. Heart Rhythm. Published 16 August 2024. doi:10.
Summarised from the published abstract; every number is checked against it