The Lead Episode 44: Intracardiac vs Transesophageal Echocardiography for Left Atrial Appendage Occlusion With Watchman FLX in the U.S.-JACC Electrophysiology (visual aid)

JACC Electrophysiology (visual aid)

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A study compared the use of intracardiac echocardiography (ICE) and transesophageal echocardiography (TEE) for the guidance of left atrial appendage occlusion (LAAO) procedures in the United States. The study analyzed data from the SURPASS (SURveillance Post Approval AnalySiS Plan) nationwide LAAO registry, which included 39,759 patients who underwent LAAO attempts between August 2020 and September 2021. The results showed that ICE was used in only 5.7% of cases, while TEE was used in 80% of cases. ICE and TEE patients had similar baseline characteristics and procedural times. The study found that both ICE and TEE achieved high rates of successful device implantation and complete LAA seal. However, ICE patients had a higher rate of pericardial effusion requiring intervention compared to TEE patients. The study concluded that ICE use was infrequent but achieved similar outcomes to TEE in terms of LAAO effectiveness. However, ICE was associated with higher rates of pericardial effusion requiring intervention. The study highlights the need for further research to evaluate the safety and effectiveness of ICE in LAAO procedures and to determine the optimal use of imaging modalities in guiding these procedures.

Keywords

intracardiac echocardiography

transesophageal echocardiography

left atrial appendage occlusion

LAAO procedures

SURPASS

LAAO registry

device implantation

complete LAA seal

pericardial effusion

imaging modalities