Intracardiac Echocardiography to Guide Left Atrial Appendage Occlusion: An Update

Milos Brankovic; Adamantios Tsangaris; Luka Petrovic; Abhishek Sharma

doi:10.31083/RCM28189

Intracardiac Echocardiography to Guide Left Atrial Appendage Occlusion: An Update

Rev Cardiovasc Med. 2025 Apr 7;26(4):28189. doi: 10.31083/RCM28189. eCollection 2025 Apr.

Authors

Milos Brankovic¹, Adamantios Tsangaris¹, Luka Petrovic², Abhishek Sharma³

Affiliations

¹ Cardiovascular Division, Department of Medicine, University of Minnesota, Minneapolis, MN 55455, USA.
² Department of Cardiology, Icahn School of Medicine, Mount Sinai Fuster Heart Hospital, Mount Sinai Morningside Hospital, New York, NY 10025, USA.
³ Division of Cardiology, Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ 07103, USA.

Abstract

The left atrial appendage occlusion (LAAO) procedure is an important intervention for stroke prevention in patients with non-valvular atrial fibrillation who cannot tolerate anticoagulation. Accurate imaging is essential to guide and ensure optimal device deployment. Transesophageal echocardiography (TEE) has traditionally been the gold standard for procedural guidance, but intracardiac echocardiography (ICE) is emerging as an alternative owing to its unique advantages. This review examines the comparative effectiveness, procedural advantages, limitations, and clinical outcomes of ICE and TEE in LAAO closure, highlighting emerging trends and implications for future clinical practice.

Keywords: ICE; LAA closure; TEE; anticoagulation; atrial fibrillation; intracardiac echocardiography; left atrial appendage occlusion; stroke; transesophageal echocardiography.

Publication types

Review