Arrhythmias & electrophysiologyMeta-analysis
Safety and efficacy of intracardiac echocardiography in atrial fibrillation ablation: a meta-analysis
- Systematic review and meta-analysis
- random-effects models
Authors' conclusion
ICE-guided AF ablation is associated with superior procedural safety and efficiency and a similar risk of AT recurrence compared to non-ICE-guided approaches.
Study context
- Population
- Patients undergoing atrial fibrillation (AF) ablation
- Participants
- 482,043 patients · 44 studies
- Comparison
- Intracardiac echocardiography (ICE)-guided vs non-ICE-guided AF ablation
- Outcome
- Efficacy, safety and procedural performance of ICE-guided vs non-ICE-guided AF ablation
Pooled result
Any complication
Odds ratio
0.69
95% CI 0.53–0.89
ICE vs Non-ICE
OR 0.69 (95% CI 0.53–0.89)
As reported in the abstract
Further pooled results
| Outcome | OR (95% CI) | |
|---|---|---|
| First-pass pulmonary vein isolation | 1.62 (1.09–2.41) | |
| Isolation of all pulmonary veins at end of procedure | 2.12 (1.37–3.27) | |
| Repeat ablation | 0.65 (0.59–0.72) | |
| 0.20.5125Odds ratio (log scale) |
Atrial tachyarrhythmia (AT) recurrence
- AT recurrence did not differ between groups
- OR 0.92; 95% CI 0.79-1.06
Procedure and fluoroscopy times, radiation exposure, contrast use
- ICE-guided ablation associated with shorter total procedure and fluoroscopy times, reduced radiation exposure and lower contrast use
Safety
| Outcome | OR (95% CI) | |
|---|---|---|
| Cardiac tamponade | 0.58 (0.53–0.62) | |
| 0.512Odds ratio (log scale) |
Original publication
Safety and efficacy of intracardiac echocardiography in atrial fibrillation ablation: a meta-analysis. Europace. Published 21 January 2026. doi:10.1093/europace/euag002
Summarised from the published abstract; every number is checked against it