Arrhythmias & electrophysiologyRandomised controlled trial
Intracardiac vs Transesophageal Echocardiography in Atrial Fibrillation Ablation
- Randomised controlled trial
- multicentre
- non-inferiority
- 10 hospitals in China
- August 2022 to July 2023
Authors' conclusion
In this multicenter randomized clinical trial, ICE was noninferior to TEE for preventing thromboembolic complications in AF ablation and offered additional advantages in safety, efficiency, and patient comfort
Study context
- Population
- Adults with atrial fibrillation (AF) scheduled for catheter ablation
- Participants
- 1,810 adults
- Comparison
- Intracardiac echocardiography (ICE) vs transesophageal echocardiography (TEE) for thrombus screening before AF ablation
- ICEn = 906
- TEEn = 904reference
- Primary endpoint
- Periprocedural thromboembolic events:
- Stroke
- TIA
- Systemic embolism
- Follow-up
- 30-day follow-up
Primary result
As reported in the abstract
Risk difference
−0.11%
95% CI −0.84% to 0.62%
P = 0.01 for non-inferiority
Events by treatment group
ICE vs TEE
risk difference −0.11% (95% CI −0.84% to 0.62%); P for non-inferiority = 0.01
Secondary outcomes
| Outcome | ICE | TEE | RR (95% CI) | P value | |
|---|---|---|---|---|---|
| Thrombus detection | 2.0% | 1.5% | 1.29 (0.64–2.61) | P = 0.48 | |
| Anxiety or depression prevalence | 24.6% | 37.5% | 0.66 (0.56–0.76) | P < 0.001 | |
| 0.20.5125Relative risk (log scale) |
Non-left atrial appendage thrombi
P < 0.001
Fluoroscopy time
P < 0.001
Preprocedural waiting time
P < 0.001
Safety
| Outcome | ICE | TEE | RR (95% CI) | P value | |
|---|---|---|---|---|---|
| Major bleeding related to transseptal puncture | 0.2% | 1.2% | 0.18 (0.04–0.81) | P = 0.03 | |
| 0.050.21520Relative risk (log scale) |
Original publication
Intracardiac vs Transesophageal Echocardiography in Atrial Fibrillation Ablation. JAMA Cardiol. Published 1 December 2025. doi:10.1001/jamacardio.2025.3687
Summarised from the published abstract; every number is checked against it