ArticleEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2023
Three-dimensional intracardiac echocardiography for left atrial appendage sizing and percutaneous occlusion guidance.
Article in Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
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Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- Intracardiac Echocardiography during Invasive Electrophysiological Procedures: a Scientific Statement of the European Heart Rhythm Association of the ESC, and the European Association of Percutaneous Cardiovascular Interventions of the ESC.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026Guideline
- Device endothelialization and morphology assessments at 1 year using computed tomography angiography: comparison of traditional with novel puncturable atrial septal defect occluders.BMC cardiovascular disorders · 2024Trial
- First-in-human experience after integration of 4D ICE with intracardiac mapping system enabling magnetic navigation and image presentation during catheter ablation of cardiac arrhythmias.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Article
- Outcomes of simplified left atrial appendage occlusion using the WATCHMAN FLX device: the ROSE-FLX study.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026Article
- Left Atrial Appendage Occlusion in the Era of Minimalist Approaches: Anesthesia and Imaging Considerations.Journal of clinical medicine · 2026Review
- Echocardiographic Guidance for Percutaneous Left Atrial Appendage Occlusion: A Systematic Review of Outcomes in High-Risk Populations Including Chronic Liver Disease and Prior Gastrointestinal Bleeding.Diagnostics (Basel, Switzerland) · 2026Review
- SCAI Position Statement on Intracardiac Echocardiography to Guide Structural Heart Disease Interventions.Journal of the Society for Cardiovascular Angiography & Interventions · 2025Article
- Intracardiac echocardiography versus transesophageal echocardiography guidance on left atrial appendage occlusion in patients with atrial fibrillation: A systematic review and meta-analysis.Journal of arrhythmia · 2025Article
- Analysis of healing status and influencing factors of iatrogenic atrial septal defect in patients with atrial fibrillation after cryoballoon ablation.European journal of medical research · 2025Article
- Simulation for Procedural Planning and Intracardiac Echo for Enhancing Precision in Cardiac Interventions With a Focus on Left Atrial Appendage Closure.Structural heart : the journal of the Heart Team · 2025Review
- A new implanter classification system for left atrial appendage closure from the European Left Atrial Appendage Closure Club (ELAACC).EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2025Article
- C-Reactive Protein-Albumin-Lymphocyte (CALLY) Index as an Independent Risk Factor for Postoperative Atrial Fibrillation Recurrence.Clinical cardiology · 2025Article
- Optimizing Imaging Techniques for Left Atrial Appendage Closure: Insights and Emerging Directions.Journal of clinical medicine · 2025Review
- Simulation for Procedural Planning and Intracardiac Echo for Enhancing Precision in Cardiac Interventions With a Focus on Left Atrial Appendage Closure.Structural heart : the journal of the Heart Team · 2025Review
- Left atrial appendage occlusion in atrial fibrillation: shaping the future of stroke prevention.Future cardiology · 2025Review
- Intracardiac Echocardiography to Guide Left Atrial Appendage Occlusion: An Update.Reviews in cardiovascular medicine · 2025Review
- Percutaneous Left Atrial Appendage Closure: Supporting Evidence, Limitations and Future Directions.Journal of clinical medicine · 2025Review
- Echocardiography evaluation of iatrogenic atrial septal defect after combined procedure of catheter ablation and left atrial appendage closure for atrial fibrillation.Scientific reports · 2025Article
- Prevalence and predictors of left atrial thrombus in patients with rheumatic atrial fibrillation undergoing cardiac surgery: a cross-sectional study.BMC cardiovascular disorders · 2025Article
- Intracardiac echocardiography improves lesion quality and ablation efficiency of pulmonary vein isolation in atrial fibrillation patients: a propensity score-matched analysis.Frontiers in cardiovascular medicine · 2025Article
Corrections and comments
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Authors and funding
25 authors at 7 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsLeft atrial appendage (LAA) imaging is critical during percutaneous occlusion procedures. 3D-intracardiac echocardiography (ICE) features direct visualization of LAA from multiple cross-sectional planes at a time. We aimed at reporting procedural success of 3D-ICE-guided LAA occlusion and the correlation between pre-procedural transoesophageal echocardiography (TEE) and intraprocedural 3D-ICE for LAA sizing. METHODS AND
resultsAmong 274 patients undergoing left atrial appendage occlusion (LAAO) with a Watchman FLX, periprocedural ICE guidance was achieved via a commercially available 2D-ICE catheter (220 patients) or a novel (NUVISION™) 3D-ICE one (54 patients). Primary endpoint was a composite of procedural success and LAA sealing at follow-up TEE. Secondary endpoint was a composite of periprocedural device recapture/resizing plus presence of leaks ≥ 3 mm at follow-up TEE. 3D-ICE measurements of maximum landing zone correlated highly with pre-procedural TEE reference values [Pearson's: 0.94; P < 0.001; bias: -0.06 (-2.39, 2.27)]. The agreement between 3D-ICE-based device selection and final device size was 96.3% vs. 79.1% with 2D-ICE (P = 0.005). The incidence of the primary endpoint was 98.1% with 3D-ICE and 97.3% with 2D-ICE (P = 0.99). 2D-ICE patients had a trend towards a higher incidence of periprocedural device recapture/redeployment (31.5% vs. 44.5%; P = 0.09). The secondary endpoint occurred in 31.5% of 3D-ICE patients vs. 45.9% of 2D-ICE ones (P = 0.065).
conclusionIntracardiac echocardiography-guided LAAO showed a very high success, with no major adverse events. A very high level of agreement for LAA sizing was found between pre-procedural TEE and periprocedural 3D-ICE. 3D-ICE performed significantly better than 2D-ICE for FLX size selection and may provide better guidance during device deployment.
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