Intracardiac Versus Transesophageal Echocardiography for Left Atrial Appendage Occlusion

BACKGROUND: The optimal imaging modality for guiding left atrial appendage occlusion remains unclear. OBJECTIVES: The authors compared the effectiveness and safety of intracardiac echocardiography (ICE) vs transesophageal echocardiography (TEE) during left atrial appendage occlusion. METHODS: Electronic databases were searched through November 2025 for studies that compared procedural success and safety with ICE vs TEE. We pooled data using a random-effects model to calculate ORs for categorical outcomes and mean differences (MDs) for continuous variables. A subgroup analysis was performed for unadjusted and adjusted data. RESULTS: = 0%). CONCLUSIONS: ICE and TEE demonstrated comparable procedural success. However, ICE was associated with shorter procedural duration at the expense of a higher incidence of intervention-requiring pericardial effusion and residual iatrogenic atrial septal defect. (Intracardiac versus Transesophageal Echocardiography for Left Atrial Appendage Occlusion: A Meta-Analysis Stratified by Adjusted and Unadjusted Subgroups; CRD420251243170).