Impact of intracardiac echocardiography versus transesophageal echocardiography guidance on left atrial appendage occlusion procedures: A meta‐analysis.
Background: Intracardiac echocardiography (ICE) is increasingly used during left atrial appendage occlusion (LAAO) as an alternative to transesophageal echocardiography (TEE). The objective of this study is to evaluate the impact of ICE versus TEE guidance during LAAO on procedural characteristics a...
| Publicado en: | Journal of Cardiovascular Electrophysiology Vol. 35; no. 1; pp. 44 - 58 |
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| Autores principales: | , , , , , , , , , , , , |
| Formato: | research systematic review tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Jan2024
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=174690498&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 174690498 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10453873 GSB jtl: Journal of Cardiovascular Electrophysiology issn: 10453873 maglogo: Y pubinfo: dt: Jan2024 vid: 35 iid: 1 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 174690498 173423856 174690498 174690498 10.1111/jce.16118 174690498 ppf: 44 ppct: 14 formats: fmt: – @attributes: type: T – @attributes: type: C – @attributes: type: P tig: atl: Impact of intracardiac echocardiography versus transesophageal echocardiography guidance on left atrial appendage occlusion procedures: A meta‐analysis. aug: au: Diaz, Juan Carlos Bastidas, Oriana Duque, Mauricio Marín, Jorge E. Aristizabal, Julian Niño, Cesar D. Hoyos, Carolina Matos, Carlos D. Gabr, Mohamed Steiger, Nathaniel A. Kapur, Sunil Sauer, William H. Romero, Jorge E. affil: Cardiac Arrhythmia and Electrophysiology Service, Universidad CES Medical School, Division of Cardiology, Clinica Las Vegas, Medellin, Colombia sug: subj: Echocardiography Methods Echocardiography, Transesophageal Left Atrial Appendage Closure Methods Treatment Outcomes Human Systematic Review Meta Analysis Confidence Intervals Odds Ratio PubMed Embase Cochrane Library ab: Background: Intracardiac echocardiography (ICE) is increasingly used during left atrial appendage occlusion (LAAO) as an alternative to transesophageal echocardiography (TEE). The objective of this study is to evaluate the impact of ICE versus TEE guidance during LAAO on procedural characteristics and acute outcomes, as well the presence of peri‐device leaks and residual septal defects during follow‐up. Methods: All studies comparing ICE‐guided versus TEE‐guided LAAO were identified. The primary outcomes were procedural efficacy and occurrence of procedure‐related complications. Secondary outcomes included lab efficiency (defined as a reduction in in‐room time), procedural time, fluoroscopy time, and presence of peri‐device leaks and residual interatrial septal defects (IASD) during follow‐up. Results: Twelve studies (n = 5637) were included. There were no differences in procedural success (98.3% vs. 97.8%; OR 0.73, 95% CI 0.42–1.27, p =.27; I2 = 0%) or adverse events (4.5% vs. 4.4%; OR 0.81 95% CI 0.56–1.16, p =.25; I2 = 0%) between the ICE‐guided and TEE‐guided groups. ICE guidance reduced in in‐room time (mean‐weighted 28.6‐min reduction in in‐room time) without differences in procedural time or fluoroscopy time. There were no differences in peri‐device leak (OR 0.93, 95% CI 0.68–1.27, p = 0.64); however, an increased prevalence of residual IASD was observed with ICE‐guided versus TEE‐guided LAAO (46.3% vs. 34.2%; OR 2.23, 95% CI 1.05–4.75, p = 0.04). Conclusion: ICE guidance is associated with similar procedural efficacy and safety, but could result in improved lab efficiency (as established by a significant reduction in in‐room time). No differences in the rate of periprocedural leaks were found. A higher prevalence of residual interatrial septal defects was observed with ICE guidance. pubtype: Academic Journal doctype: meta analysis research systematic review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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