Echocardiography; Intracardiac; Left atrial appendage; Occlusion; Transesophageal; Humans; Predictive Value of Tests; Treatment Outcome; Aged; Female; Male; Risk Factors; Middle Aged; Atrial Appendage/diagnostic imaging; Atrial Appendage/physiopathology; Echocardiography, Transesophageal/adverse effects; Atrial Fibrillation/physiopathology; Atrial Fibrillation/diagnostic imaging; Atrial Fibrillation/therapy; Ultrasonography, Interventional/adverse effects; Cardiac Catheterization/adverse effects; Cardiac Catheterization/instrumentation; Aged, 80 and over; Atrial Appendage; Atrial Fibrillation; Cardiac Catheterization; Echocardiography, Transesophageal; Ultrasonography, Interventional; Radiology, Nuclear Medicine and Imaging; Cardiology and Cardiovascular Medicine
Abstract :
[en] [en] 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.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
Beneki, Eirini; First Cardiology Department, School of Medicine, Hippokration General Hospital, National and Kapodistrian University of Athens, Athens, Greece. e.beneki@hotmail.com ; Department of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. e.beneki@hotmail.com
Dimitriadis, Kyriakos; First Cardiology Department, School of Medicine, Hippokration General Hospital, National and Kapodistrian University of Athens, Athens, Greece
Theofilis, Panagiotis; First Cardiology Department, School of Medicine, Hippokration General Hospital, National and Kapodistrian University of Athens, Athens, Greece
Pyrpyris, Nikolaos; First Cardiology Department, School of Medicine, Hippokration General Hospital, National and Kapodistrian University of Athens, Athens, Greece
Iliakis, Panayiotis; First Cardiology Department, School of Medicine, Hippokration General Hospital, National and Kapodistrian University of Athens, Athens, Greece
Kalompatsou, Argyro; First Cardiology Department, School of Medicine, Hippokration General Hospital, National and Kapodistrian University of Athens, Athens, Greece
Kostakis, Panagiotis; First Cardiology Department, School of Medicine, Hippokration General Hospital, National and Kapodistrian University of Athens, Athens, Greece
Koukos, Markos; First Cardiology Department, School of Medicine, Hippokration General Hospital, National and Kapodistrian University of Athens, Athens, Greece
Soulaidopoulos, Stergios; First Cardiology Department, School of Medicine, Hippokration General Hospital, National and Kapodistrian University of Athens, Athens, Greece
Tzimas, Georgios; Department of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
Tsioufis, Konstantinos; First Cardiology Department, School of Medicine, Hippokration General Hospital, National and Kapodistrian University of Athens, Athens, Greece
Lancellotti, Patrizio ; Université de Liège - ULiège > Département des sciences cliniques > Cardiologie - Pathologie spéciale et réhabilitation
Aggeli, Constantina; First Cardiology Department, School of Medicine, Hippokration General Hospital, National and Kapodistrian University of Athens, Athens, Greece
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