The Emerging Role of Intracardiac Echocardiography (ICE) in Left Atrial Appendage Closure (LAAC)

Curr Cardiol Rep. 2023 Oct;25(10):1223-1232. doi: 10.1007/s11886-023-01940-4. Epub 2023 Aug 23.

Abstract

Purpose of review: Intracardiac echocardiography (ICE) has emerged as a powerful imaging tool to guide percutaneous left atrial appendage closure (LAAC). Herein, we review an imaging protocol for ICE-guided LAAC and discuss the evidence for its use.

Recent findings: Standardized imaging protocols have been proposed but have not been fully validated. ICE imaging yields similar procedural and clinical outcomes when compared to transesophageal echocardiography (TEE) to guide LAAC. Despite benefits of avoiding general anesthesia, TEE, and multiple physicians for LAAC procedures, ICE imaging remains under-utilized. Novel ICE catheters with 3D imaging capabilities may improve accuracy and efficiency of LAAC device implantation. ICE guidance is feasible, safe, and effective for LAAC. As the field evolves, further studies will be necessary to assess this technological advancement in imaging guidance.

Keywords: ICE; Intracardiac echocardiography; LAAC; LAAO; Left atrial appendage closure; Left atrial appendage occlusion.

Publication types

  • Review

MeSH terms

  • Atrial Appendage* / diagnostic imaging
  • Atrial Appendage* / surgery
  • Atrial Fibrillation* / diagnostic imaging
  • Atrial Fibrillation* / surgery
  • Cardiac Catheterization / methods
  • Cardiac Surgical Procedures*
  • Echocardiography, Transesophageal
  • Humans
  • Treatment Outcome