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Review
. 2024 Mar 12:13:e03.
doi: 10.15420/aer.2023.29. eCollection 2024.

Intracardiac Echocardiography-guided Left Atrial Appendage Occlusion

Juan Carlos Diaz  1 , Mauricio Duque  2 , Jorge Marin  3 , Julian Aristizabal  2 , Cesar Niño  4 , Oriana Bastidas  4 , Carlos D Matos  5 , Carolina Hoyos  5 , Daniela Hincapie  5 , Jorge E Romero  5
Affiliations
Review

Intracardiac Echocardiography-guided Left Atrial Appendage Occlusion

Juan Carlos Diaz et al. Arrhythm Electrophysiol Rev. .

Abstract

Left atrial appendage occlusion (LAAO) is a suitable alternative to oral anticoagulant therapy to prevent stroke in patients with AF. Most procedures are performed under transoesophageal echocardiography (TOE) guidance, which facilitates transseptal puncture, reduces the risk of procedurerelated complications and provides an additional method for device selection and real-time monitoring during device deployment. However, TOE has significant shortcomings, including the need for general anaesthesia/deep sedation as well as a significant risk of procedure-related adverse events. More recently, intracardiac echocardiography has been proposed as an alternative to TOE guidance during LAAO procedures. In this review, we summarise the available evidence as well as providing a step-by-step approach for intracardiac echocardiography-guided LAAO.

Keywords: Left atrial appendage occlusion; atrial fibrillation; intracardiac echocardiography; transoesophageal echocardiography.

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Conflict of interest statement

Disclosure: JD and JR have received speaker honoraria and are proctors for Boston Scientific. All other authors have no conflicts of interest to declare.

Figures

Figure 1:
Figure 1:. Initial Images Obtained From the Right Cardiac Chambers
Figure 2:
Figure 2:. View of the Interatrial Septum During Transseptal Puncture
Figure 3:
Figure 3:. Basic Intracardiac Echocardiography Catheter Positions to Guide LAAO
Figure 4:
Figure 4:. Representation of the Location of the Intracardiac Echocardiography Catheter within the LA to Obtain Different Views
Figure 5:
Figure 5:. Evaluation of Device Position, Compression and Stability
See this image and copyright information in PMC

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