SynthesisEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2026
Safety and efficacy of intracardiac echocardiography in atrial fibrillation ablation: a meta-analysis.
Synthesis 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, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- 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
- Fluoroless Workflow for Pulsed Field Ablation of Atrial Fibrillation Using the Sphere-9 and VARIPULSE Catheters.Journal of clinical medicine · 2026Review
- Three-Dimensional Left Atrial Geometry in Atrial Fibrillation: Imaging Biomarkers, Substrate Phenotyping, and Ablation Outcome Prediction.Diagnostics (Basel, Switzerland) · 2026Review
- Role of High-Resolution Computed Tomography in Double-Lumen Tube Selection for Patients Undergoing Minimally Invasive Coronary Bypass.Journal of clinical medicine · 2026Article
- The Role of Multimodality Imaging in Atrial Fibrillation and Heart Failure: From Patient Selection to Procedural Ablation Guidance.Medicina (Kaunas, Lithuania) · 2026Review
- Atrial fibrillation ablation using real-time three-dimensional transesophageal echocardiography as the primary intraprocedural imaging modality: a single-center feasibility study.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Article
Corrections and comments
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsIntracardiac echocardiography (ICE) is increasingly incorporated into atrial fibrillation (AF) ablation workflows, enabling real-time anatomic guidance and procedural precision. Nevertheless, ICE utilization shows substantial geographic variability, and its clinical benefit remains incompletely understood. This meta-analysis evaluated the efficacy, safety, and procedural performance of ICE-guided vs. non-ICE-guided AF ablation. METHODS AND
resultsMEDLINE, the Cochrane Library, and Scopus were systematically searched through 3 August 2025. Three reviewers independently performed study selection, data extraction, and risk-of-bias assessment. Random-effects models were used to pool data from 44 AF ablation studies comprising 482 043 patients. ICE guidance was associated with lower odds of any complication (OR 0.69; 95% CI 0.53-0.89), including significant reductions in cardiac tamponade (OR 0.58; 95% CI 0.53-0.62) and mortality (OR 0.21; 95% CI 0.16-0.27). ICE-guided ablation was also associated with shorter total procedure and fluoroscopy times, reduced radiation exposure, and lower contrast agent utilization. Atrial tachyarrhythmia (AT) recurrence did not differ between groups (OR 0.92; 95% CI 0.79-1.06). However, ICE use was associated with higher odds of first-pass pulmonary vein isolation (OR 1.62; 95% CI 1.09-2.41) and successful isolation of all pulmonary veins at the end of the procedure (OR 2.12; 95% CI 1.37-3.27), and lower odds of repeat ablation (OR 0.65; 95% CI 0.59-0.72).
conclusionICE-guided AF ablation is associated with superior procedural safety and efficiency and a similar risk of AT recurrence compared to non-ICE-guided approaches.
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